During this session, Mara McDermott, Vice President, McDermott+Consulting, moderated a panel that discussed the current political and policymaking environment on Capitol Hill and what to watch for in 2023.

Session panelists included:

• Dr. Lauren Lyles-Stolz, Senior Director, Reimbursement, Innovation and Advocacy, National Association of Chain Drug Stores (NACDS)
• Mara McDermott, Vice President, McDermott+Consulting (Moderator)
• Aisha Pittman, Senior Vice President, Government Affairs, National Association of ACOs (NAACOS)
• Soumi Saha, Senior Vice President of Government Affairs, Premier Inc.

IN DEPTH

Top takeaways included:

1. Legislative and regulatory stakeholders have created a number of opportunities to engage in value-based care, including through the creation of the Center for Medicare and Medicaid Innovation (CMMI) and the Medicare Shared Savings Progam (MSSP). However, many of these initiatives have been—and continue to be—influenced by political and agency decision making. Therefore, educating members of Congress on why value is important remains a top priority.
2. Stakeholders are advocating for greater predictability and alignment across value-based initiatives. There are many competing interests in the system today, with Centers for Medicare & Medicaid Services (CMS) initiatives trending in different directions (e.g., Medicare Advantage versus MSSP). There are questions regarding how pharmacy services can better integrate into value-based care, how to engage specialists, how to sustain Medicare Advantage and more. Creating a pathway for all of these initiatives and stakeholders to coexist will be challenging, but could lead to greater value.
3. Better data is needed across programs. Faster, higher-quality data would allow CMS to more quickly cost-correct during the implementation of its value-based models and other initiatives. More data—ranging from program benchmarks to how health equity is calculated and accounted for—is needed to support and address ongoing technical challenges.
4. As Congress looks at reimbursement as a whole, incentives will be critical to encouraging the adoption of value-based care. How legislative and regulatory stakeholders design new initiatives and revise existing models will influence providers’ willingness to participate, as providers and other stakeholders continue to juggle competing priorities.