Medicare Rights Center Endorses CMS Proposal to Test Value-Based Payment Strategies for Part B Medications

New York, NY—The Medicare Rights Center (Medicare Rights) today sent a letter to Sylvia Mathews Burwell, secretary of the Department of Health & Human Services (HHS) and Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), to express support for CMS’ proposal to test value-based payment strategies for prescription drugs covered under Medicare Part B.

“We remain strongly supportive of commitments made by HHS and CMS to transition Medicare to a high-value health care system through testing and innovations intended to enhance health care quality and lower costs,” said Joe Baker, president of Medicare Rights. “Through over two decades of experience counseling people with Medicare and their families, we can attest that this proposed test of Part B drug payment rates has the potential to alleviate persistent deficits in care.”

According to CMS, the current Part B prescription drug reimbursement model, determined by Average Sales Price (ASP) plus six percent, establishes a perverse incentive to prescribe higher cost medications. The experiment proposes to test a variety of reimbursement methods and value-based purchasing innovations, many of which are already in use in the private insurance market and will promote utilization of the most clinically effective medications—not the most costly. It also proposes to test multiple strategies to encourage the use of high-value medications, especially those that eliminate or lower beneficiary cost sharing and promote the adoption of evidence-based clinical decision support tools.

“We’re confident that CMS’ proposed payment model will preserve beneficiary access to needed prescription drugs, while also advancing innovative strategies to ensure that people who need Part B medications receive the highest value care available to them,” said Baker. “We believe the proposal can yield results meaningful to today’s beneficiaries, through enhanced care quality, and to future generations, through a stronger and more sustainable Medicare program.”

Read the letter.

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