MSMS Submits Comments to MDHHS on SIM Payment Model

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MSMS Submits Comments to MDHHS on SIM Payment Model

Wednesday, August 24, 2016

The Michigan State Medical Society recently submitted comments to Michigan Department of Health and Human Services (MDHHS) on the State Innovation Model (SIM) proposal for a custom payment option under the Centers for Medicare and Medicaid Services (CMS) demonstration. MSMS supports SIM and CMS in their efforts to move physician practices toward value-based reimbursement models but identified a number of challenges in the custom payment option as proposed by MDHHS.

MSMS, with input from its partners on the Executive Council of Physician Organizations, drafted a number of recommendations to address the challenges and improve the chances for successful SIM implementation. The recommendations centered on the need for greater simplicity and alignment across payment models between Medicare, Medicaid and commercial payers in Michigan.

Specifically, MSMS recommended a one-year continuation of the MiPCT per-member-per-month payments to allow for consistency of care management services, particularly for independent, private practice in rural or underserved areas. Much of the feedback from Executive Council partners focused on the challenges to sustain important care management services for chronically ill patients without these funds.

Additionally, MSMS recommended recognition of the role physician organizations provide to practices in terms of infrastructure, staffing and training support. MSMS strongly recommended alignment with other CMS initiatives such as existing Accountable Care Organizations (ACOs) and the pending Comprehensive Primary Care Plus (CPC+) models. Read MSMS's full recommendations to MDHHS >>

At the SIM Kick-Off Summit earlier this month, MDHHS announced it would accept the recommendations made by MSMS and incorporate a significant portion of these items into its custom payment option design. MSMS appreciates the partnership with MDHHS to develop a SIM model that works best for Michigan practices.