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Payment Models

As our healthcare system continues to innovate ways to incentivize quality over quantity, we must ensure that health disparities and social determinants are addressed if we are to achieve health equity. Years of research have revealed the link between non-medical factors and poor health outcomes. New payment models must be equipped to address the factors that drive high healthcare costs and poor outcomes. This is particularly true among vulnerable populations, who often live with higher rates of chronic disease and less access to health care services. As shared in our 8-point-call-to-action TRCC highlights policies that would help ensure payment to care providers and non-clinical community- based organizations to reduce costs and advance health equity.  

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John Lewis Equality in Medicare and Medicaid (EMMT) Act 

H.R. 3069 - Representative Terri Sewell (D-AL)

  • Introduced on 5/2/23

  • 6 Co-Sponsors as of 8/4/23

S. 1296 - Senator Cory Booker (D-NJ)

  • Introduced on 4/26/23

  • 2 Co-Sponsors as of 8/4/23

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Description

The bill would:

  • Direct the Center for Medicare and Medicaid Innovation (CMMI) to consult with experts on health disparities, such as the Office of Minority Health of the Centers for Medicare & Medicaid Services, the Federal Office of Rural Health Policy, and the Office on Women’s Health, on developing new payment models that focus not only on lowering costs but also advancing health equity and improving access to care.

  • Focus on creating and testing new value-based payment models. Currently, it is not mandated to take into account social determinants of health like a patient's environment, education, and economic background during the testing and implementation of new payment models.

Status

  • The bills remain under consideration in the House Energy and Commerce and Ways and Means Committees and the Senate Committee on Finance

Additional Information

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