Congressional move to rein in innovations that harm people, Connecticut advocates’ SIM concerns addressed in DC

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A new bill in Congress, proposed by both Democrats and Republicans, would place controls on federal grants for payment and delivery reform projects. The Strengthening Innovation in Medicare and Medicaid Act was introduced last week to “increase transparency and accountability within the federal Center for Medicare and Medicaid Innovation (CMMI)”. CMMI is the federal agency that funded and guided Connecticut’s controversial SIM program that ended last month, having accomplished little for the state. Congressional sponsors support CMMI’s critical mission to promote value in healthcare but are concerned that the new models may harm people, especially underserved populations, and do not require effective public input. The bill requires HHS to “to develop and implement a plan to monitor the effect of a model on applicable individuals, and mitigate any adverse impact, including reductions in care or reduced access to care” and expands requirements for public input. These concerns were voiced by independent consumer advocates in Connecticut’s SIM plans over several years but were largely dismissed. It was suggested that advocates just didn’t understand and needed educating about the models. The bill also requires HHS to monitor the impact of CMMI initiatives on health disparities and mitigate harm to health outcomes. It’s interesting that these problems were not limited to Connecticut’s SIM process but appear to be a problem across the US. While Connecticut policymakers largely ignored underservice and lack of public input concerns during the SIM years, it is gratifying that there is bipartisan recognition and action on these concerns in Congress.