Reexamining Medicare Payment Reforms in Light of COVID-19

Multipayer Primary Care Network Primary Care Transformation Delivery System Reform Population Health COVID-19

If the United States paid for health care differently, would we have a more pandemic-responsive health care delivery system? In an article published today in NEJM Catalyst, Christopher F. Koller, president of the Milbank Memorial Fund, and Patrick Conway, MD, senior executive in residence at Optum, propose that, along with cost and quality, policymakers consider adding an “epidemic mitigation” standard to their evaluations of payment reform models, especially for primary care.

Specifically, the Center for Medicare and Medicaid Innovation (CMMI) could evaluate whether current and future payment reforms improve the ability of the health care delivery system to help treat infectious disease outbreaks and prevent them from becoming society-paralyzing pandemics. The Comprehensive Primary Care Plus (CPC+) initiative is an example of a CMMI payment model that meets this standard.

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