A Conversation with CMMI, AHRQ, and PCORI on Value-Based Purchasing
4:30 PM – 5:15 PM
With the passage of MACRA and Hospital Value-Based Purchasing, physician and hospital payments have moved toward performance-based pricing. However, the meaning of “paying for value” varies among patients/family caregivers, industry, and payers. Value frameworks do not currently capture the unique choices that older adult patients face, which means that the needs of older patients, who typically manage 3-5 chronic conditions and take multiple drugs simultaneously, are largely excluded from the value equation.
This panel brought together CMMI, AHRQ, and PCORI to explore how to incorporate the older adult patient/family perspective into the value equation; understand the potential impact of value-based models on access to innovative care; and, discuss how the shift to value may shape quality of care moving forward.
Susan Peschin, MHS, is president and CEO at the Alliance for Aging Research. The Alliance for Aging Research is dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health. For more than 30 years, the Alliance has guided efforts to substantially increase funding and focus for aging at the NIH, FDA, AHRQ, and CDC; built influential coalitions to guide groundbreaking regulatory improvements for age-related diseases; and created award-winning, high-impact educational materials to improve the health and well-being of older adults and their family caregivers.
Since 2012, Ms. Peschin has been a driving force in the growth and success of the organization. Under her leadership, the Alliance has remained strong in these priorities and continued to build on its reputation as a forward-thinking public policy and health education organization. As president and CEO, she leads the strategic development and implementation of Alliance initiatives, as well as manages Board governance and organizational operations. As a thought leader on many aging-related issues, she has led the Alliance in efforts to: boost older adult immunization rates; increase NIH Alzheimer’s disease and aging research funding; raise awareness of geriatric cardiac issues; develop a senior patient and family caregiver network through a PCORI engagement grant; and co-organize a first-ever NIH geroscience summit. She participates in major industry and policy symposiums around the country each year, and has published opinion pieces in news outlets nationwide.
Ms. Peschin currently serves on the Board of Heart Valve Voice U.S. and the National Council on Patient Information and Education; on the World Economic Forum’s Council on Human Enhancement; on the National Advisory Council for the National Institute on Aging at the NIH; on the Steering Committee for the Coalition for Imaging & Bioengineering Research; and as a member of the Lifespan Domain Task Force for the Clinical & Translational Science Award program, funded by NCATS at the NIH.
Ms. Peschin earned a BA in Sociology from Brandeis University, and a MHS degree in Health Policy from the Johns Hopkins University Bloomberg School of Public Health.
Amy Bassano is the Deputy Director of the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services. Prior to assuming this position in April 2016, Ms. Bassano was the Director of the Patient Care Models Group at CMMI leading CMS’s efforts on bundled payments including the Bundled Payments for Care Improvement (BPCI) Initiative and the Comprehensive Care for Joint Replacement (CJR) model and the development of physician specialty models such as the Oncology Care Model. In addition, she was responsible for the Home Health Value Based Purchasing Model and the Medicare Care Choices Model. Ms. Bassano also held senior management positions in the Center for Medicare at CMS overseeing Medicare payment policy for a variety of areas including inpatient and outpatient hospitals, physicians, ambulatory surgical centers, clinical laboratories, and Part B drugs. Prior to her tenure at CMS, Ms. Bassano was a Program Examiner at the Office of Management and Budget where she was the lead Medicare analyst on Medicare Part B and D issues. Ms. Bassano has an MA in Policy Studies from Johns Hopkins University and a BA in history from Tufts University.
Arlene S. Bierman, MD, MS, leads the work of CEPI, which consists of five divisions: the Evidence-Based Practice Center Program; the U.S. Preventive Services Task Force Program; the Division of Decision Science and Patient Engagement; the Division of Health Information Technology; and the Division of Practice Improvement, as well as the National Center for Excellence in Primary Care Research. Dr. Bierman is a general internist, geriatrician, and health services researcher, whose work has focused on improving access, quality, and outcomes of health care for older adults with chronic illness in disadvantaged populations. Dr. Bierman has also developed strategies for using performance measurement as a tool for knowledge translation and has conducted research to increase policymakers’ use of evidence.
As a tenured professor, she held appointments in health policy, evaluation, and management; public health; medicine; and nursing at the University of Toronto, where she was the inaugural holder of the Ontario Women’s Health Council Chair in Women’s Health and a senior scientist in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital. Dr. Bierman was also principal investigator for the Project for an Ontario Women’s Health Evidence-Based Report Card (POWER) study, which provided actionable data to help policymakers and health care providers improve health and reduce health inequities in Ontario.
Dr. Bierman has served on many advisory committees, including the Geriatric Measurement Advisory Panel of the National Committee for Quality Assurance and the boards of Health Quality Ontario and the National Center of Excellence National Initiative for Care of the Elderly (NICE). She received her MD degree from the University of North Carolina School of Medicine in Chapel Hill where she was a Morehead Fellow. She completed fellowships in outcomes research at Dartmouth Medical School and community and preventive medicine at the Mount Sinai School of Medicine. She also served as an Atlantic Philanthropies Health and Aging Policy Fellow/American Political Science Foundation Congressional/Fellow.
A family physician, clinical epidemiologist, and health services researcher, Selby has more than 35 years of experience in patient care, research, and administration. He is responsible for identifying strategic issues and opportunities for PCORI and implementing and administering programs authorized by the PCORI Board of Governors.
Selby joined PCORI from Kaiser Permanente, Northern California, where he was Director of the Division of Research for 13 years and oversaw a department of more than 50 investigators and 500 research staff members working on more than 250 ongoing studies. He was with Kaiser Permanente for 27 years. An accomplished researcher, Selby has authored more than 200 peer-reviewed articles and continues to conduct research, primarily in the areas of diabetes outcomes and quality improvement. His publications cover a spectrum of topics, including effectiveness studies of colorectal cancer screening strategies; treatment effectiveness, population management, and disparities in diabetes mellitus; primary care delivery; and quality measurement. Selby was elected to membership in the Institute of Medicine in 2009 and was a member of the Agency for Healthcare Research and Quality study section for Health Care Quality and Effectiveness from 1999 to 2003.
A native of Fulton, Missouri, Selby received his MD from Northwestern University and his MPH from the University of California, Berkeley. He was a commissioned officer in the Public Health Service Corps from 1976 to 1983 and received the Commissioned Officer’s Award in 1981.
Barry Liden is Vice President of Patient Engagement for Edwards Lifesciences (NYSE:EW), the global leader in patient-focused innovations for structural heart disease and critical care monitoring. He is responsible for helping the Irvine, California-based company engage with, learn from and empower patients and their families to improve the healthcare experience. Liden joined Edwards in 2002 as Director of Global Communications, responsible for the company’s external public relations, and has served in a number of public affairs positions, most recently as Vice President of Government Affairs, responsible for public policy development and advocacy.
Before joining Edwards, Liden served for three years as Vice President for public affairs at Rogers & Associates, the largest privately-owned strategic public relations agency on the West coast, and for four years as Principal at Dallas-based Bustin & Co., an integrated marketing consultancy. He began his public affairs career in 1990 as the Director of Government Relations for the Los Angeles Area Chamber of Commerce, responsible for transportation and environmental policy development and advocacy for the greater L.A. business community.
For more than 25 years, Liden has integrated public policy, government relations, marketing, public relations and crisis management practices to provide strategic solutions to his clients and employers’ challenges. He enjoyed sharing this experience with public relations undergraduate students at the University of Southern California as an adjunct faculty member in the Annenberg School for Communications for seven years before moving to the Washington, D.C. area in 2007.
Liden has a bachelor of science in public administration from the University of Southern California, and a juris doctor from Loyola Law School of Los Angeles. He lives in Garrett Park, Maryland with his wife Tracy and three sons, Jack, Nick and Luke.