Medicare Rights Center Identifies Consumer Protections for New Medicare Payment and Delivery Models

The Medicare Rights Center joined with the AARP Public Policy Institute to release a new report, Consumer Protections in New Medicare Payment and Delivery Models: A Checklist. This checklist is the result of a partnership between Medicare Rights and the AARP Public Policy Institute in which we identified a set of concrete consumer protections that we believe should be integrated into the design of all Medicare models.

The Affordable Care Act established the Center for Medicare & Medicaid Innovation (CMMI) within the Centers for Medicare & Medicaid Services (CMS) to find ways to reduce the cost of health care while improving its quality. CMMI is now developing and improving various value-based models to test new ways for Medicare to pay for and deliver care. Such models aim to reward value over volume and improve health outcomes for people with Medicare while reducing costs to the Medicare program. But as models are introduced and evaluated, we must make sure that any changes to Medicare payment do not diminish access to care, care quality, or the overall consumer experience with the Medicare system.

Medicare is a vital source of health care for 57 million older adults and people with disabilities. A shift in payment design to reward value could help the program continue to provide high-quality care with fewer resources, but payment and delivery reforms will achieve their goals most effectively if people with Medicare are given the information they need and a voice in the process.

Drawing upon our experience with our national helpline, we recognize that providing understandable and complete information is the foundation of good Medicare policy. This is reflected in our checklist priorities.

The consumer protections checklist is split into three sections:

1. Models should offer more effective information and assistance to consumers, caregivers, and families;
2. Models should engage consumers, caregivers, and families; and
3. Models should improve transparency and oversight.

Within each of these sections, we have provided ideas that CMMI can use internally as well as protections they should suggest or require of participating plans and providers.

While this checklist is targeted specifically at CMS and CMMI, it could be a useful resource in future model development by any agency or organization.

It is vital that we always give beneficiaries the information they need to make good choices and that we always listen when they speak. With appropriate safeguards in place, future Medicare models have the potential to improve health care for millions of people.

Consumer Protections in New Medicare Payment and Delivery Models: A Checklist is available at https://www.aarp.org/ppi/info-2017/consumer-protections-in-new-medicare-payment-and-delivery-models.html.

Support for this work was provided by AARP. The views presented here are those of the author and not necessarily those of AARP or its directors, officers, or staff.