WASHINGTON, D.C. - U.S. Senator Cory Booker (D-NJ) today introduced legislation that would require the Center for Medicare and Medicaid Innovation (CMMI) to address disparities in health care access and outcomes when developing new payment and delivery models for care provided to patients, including Medicaid, Medicare and Children’s Health Insurance Program (CHIP) beneficiaries. Under the Equality in Medicare and Medicaid Treatment Act, CMMI would be required 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 any new payment models under development. In 2019, Congressman John Lewis introduced the bill in the House of Representatives.
The Center for Medicare and Medicaid Innovation (CMMI) was created under the Affordable Care Act to develop and test new health care payment models that reduce health care costs while also maintaining or improving quality of care. Since its enactment, CMMI has created and implemented 37 different payment models with the most well-known three being bundled payments, accountable care organizations, and patient-centered medical homes. Some of the models CMMI has implemented so far include models to improve diabetes care and facilitate home-based primary care.
However, under current law, CMMI is not specifically required to consider and address health disparities and social determinants of health, such as a patient’s environment, education, and economic status, when implementing and testing new payment models. These factors primarily impact the health outcomes of rural, low-income, and communities of color and not addressing these issues can lead to larger health disparities and inequities among these communities.
“At a time when the disturbing inequities in access to health care and health outcomes have been exacerbated by this public health crisis, we need to be using every tool we have to improve the quality of and access to care, especially for the marginalized,” said Senator Booker. “We know that how we pay for health care can directly impact the health outcomes we achieve, and the Equality in Medicare and Medicaid Treatment Act will seek to ensure that as we develop new ways to deliver and pay for health care, we are not exacerbating existing inequities but devoting attention and resources to closing them, and improving health outcomes for everyone.”
The Equality in Medicare and Medicaid Treatment Act would also require CMMI to consider health care delivery innovations for individuals with behavioral health conditions, pregnant people, and people who are enrolled in both Medicaid and Medicare (dual eligible). Should the Secretary of HHS wish to expand a payment model tested by the CMMI, the bill would require that the Office of Minority Health at CMS certify that such expansion would not reduce access to care or increase disparities for beneficiaries who are low-income, live in a rural area, or are people of color.
Throughout his time in Congress, Booker has championed legislation to improve health outcomes and reduce health inequities, including the REDUCE Act, which he most recently introduced with Congressman Bill Pascrell, Jr. (D-NJ) in 2019. The legislation is aimed at reducing disparities in health care among marginalized groups.
The full text of the Equality in Medicare and Medicaid Treatment Act can be downloaded here.