Source: Politico
The Trump administration is scrapping the Biden administration’s plans to create a list of $2 generic drugs and have Medicare pay less for accelerated approval drugs.
The Center for Medicare and Medicaid Innovation also said Wednesday that it is ending four payment models early, including two focused on investing in primary care.
CMMI did not give a reason for the decision, only that all the changes were to “align its statutory mandate and strategic goals,” according to an update released Wednesday.
The innovation center said it regularly assesses and could amend models in response to “projected savings, quality outcomes data, legal compliance, operational feasibility and gaps in expected versus actual impact.”
CMMI will end early the:
- Maryland Total Cost of Care model, which launched in 2019 and allows the state to cap hospital expenditures. Going forward it will transition to the similar AHEAD Model. The Maryland model will end after this year;
- Primary Care First, which boosts pay for doctors if they meet quality metrics such as controlling high blood pressure and more cancer screenings. It will also expire after 2025;
- Making Care Primary, a voluntary model that started last year, aims to boost coordination between primary care doctors, specialists and behavioral health clinicians to improve health outcomes. The model was expected to run for 10 years but now will end early, although CMS did not specify when; and
- End-Stage Renal Disease Treatment Choices, a mandatory model intended to boost home dialysis use. CMS intends to issue a rule to get rid of the model by the end of the year.
The center tests changes to Medicare payments to boost savings and quality. Congressional Republicans have scrutinized the center for not generating enough savings since Congress created it in 2010’s Affordable Care Act.
Under Trump, CMMI has also ended the collection of demographic data and a requirement by payment model participants to submit a plan to close health equity gaps.
