Senators Issue Bipartisan Call to Move Away from Fee-For-Service Medicare

A pair of United States senators asked new Health and Human Services Secretary Alex Azar to focus on developing alternative payment models for Medicare — while moving away from traditional fee-for-service (FFS) Medicare.

“As the largest purchaser of health care in the United States, the federal government needs to send a strong signal that paying for volume via fee-for-service is not the direction in which our health care system is headed,” Sen. Bill Cassidy and Sen. Sheldon Whitehouse wrote in the March 16 letter. “Any real or perceived absence of federal leadership will slow private-sector momentum toward alternative payment models.”

The senators — a Republican from Louisiana and a Democrat from Rhode Island, respectively — referenced comments that Azar made during his confirmation hearing, in which he noted that only Medicare has the scale to inspire reform across all payors.


Unlike his predecessor, former HHS Secretary Tom Price, Azar has expressed significant support for the development of alternative payment models. In a speech to Federation of American Hospitals earlier this month, he made it clear that he isn’t willing to wait for payment reform.

“I don’t intend to spend the next several years tinkering with how to build the very best joint-replacement model — we want to look at bold measures that will fundamentally reorient how Medicare and Medicaid pay for care, and create a true competitive playing field where value is rewarded handsomely,” Azar said at the time.

Cassidy and Whitehouse both applauded the progress that has been made in reshaping the way health care providers are reimbursed, and called on Azar to make sure that the momentum continues under the Trump administration.


“Without your focused attention on moving forward, in addition to looking back, our health care system is at serious risk of backsliding on the progress Medicare, private payers, and states have made in changing the way they pay for care,” the senators wrote.

They specifically pointed to the work that the Center for Medicare and Medicaid Innovation (CMMI) has done to drive the payment-reform conversation in Washington toward prioritizing better outcomes and lower overall costs.

“Leading health care experts and private sector partners strongly support these ideas, are supportive of CMS’s leadership role, and are willing to provide thoughtful advice on metrics and goals for payment and delivery system reform,” the senators wrote before inviting Azar to provide direct input to Congress on reform.

Written by Alex Spanko

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