Board Chair, Dr. Kathleen Squires, submitted public comments to CMS on behalf of HIVMA, in response to a request for information concerning Accountable Care Organizations and the Medicare Shared Saving Program. Key points are as follows:
HIVMA strongly supports efforts to integrate service delivery to improve the delivery of patient-centered, high quality care and encourage efficiencies in health care spending.
When seeking to meet these goals by employing new models such as Accountable Care Organizations (ACOs) strong protections must be in place for patients with HIV and other complex chronic conditions to ensure health outcomes are not compromised for cost savings.
Patients with HIV require access to a comprehensive array of services to ensure that their unique medical and psychosocial needs are met to facilitate care and treatment adherence.
Patients with HIV must have open and reliable access to a qualified HIV medical provider and have the option to designate an HIV medical provider as their primary care provider.
Medicare ACOs should be expected to provide the standard of care recommended by the federal guidelines and recognized professional organizations, and ensure services available at a minimum that reflect these are standards.
Payment models that reflect the cost of providing chronic, complex care must be employed by ACOs to meet the medical needs of patients with HIV. HIVMA urges CMS to support a pilot under the new Center for Medicare and Medicaid Innovation to document and evaluate, in terms of patient outcomes and cost of care, the Ryan White model for patient-centered medical home care.
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