The move to value-based payments in Medicare needs refinement to recognize the value of medical technology, a key medical device industry group said.
The problem with the current system, the Advanced Medical Technology Association said in a report issued Dec. 19, is inadequate measures of quality that underpin this payment system can mean patients aren’t getting optimum care and costs may be the key driver, not patient outcomes.
“This study underscores the uneven playing field on which medical technology is judged, potentially depriving American patients of the innovative care they deserve,” Scott Whitaker, president and CEO of the group, said in an accompanying statement.
AdvaMed said quality measures are essential to VBP as the health system moves away from paying based on volume. The industry group said the lack of certain quality measures for device use and data collection can lead to overuse or underuse of devices and services, safety issues, and stifled innovation. AdvaMed said examples of what it called quality measure gaps exist for common procedures such as hip and knee implants, glucose monitoring, and remote patient monitoring.
The industry group wants the Centers for Medicare & Medicaid Services to add quality measures that reflect the value of medical technology in what it called “payer-developed core measure sets,” referring to health insurers. Other parts of the health-care industry should work with device makers to find and close existing gaps, AdvaMed said.
Don May, executive vice president at the device trade group, which represents 80 percent of medical technology companies in the U.S., told me the gaps exist because quality measure developers haven’t looked at the “device angle.”
Thomas Beimers, a health-care attorney at Hogan Lovells’s Minneapolis office, told me that payers, like insurance companies and the CMS, are driving value-based payments and everyone in the health-care industry is starting to get on board, including device makers.
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