On Friday, the Centers for Medicare and Medicaid Services said it has decided to call off the Direct Decision Support Model.
According to a statement on the DDS Model web page:
CMS is not moving forward with the DDS Model due to operational and technical issues with the proposed Model design. After careful consideration and review of all available options, CMS determined that the design and operational changes necessary to continue with the DDS Model would be too significant and burdensome for participants, and would require a new solicitation.
The CMS Innovation Center program’s goal was to help patients make better decisions about their care and engage them in their health outside of the clinical setting.
The model worked like this: CMS would team up with seven decision support organizations, which provide health management services, to help a total of 700,000 Medicare beneficiaries each year. The DSOs were supposed to focus on patients with several conditions: hip osteoarthritis; herniated disk or spinal stenosis; stable ischemic heart disease; prostate cancer; benign prostate hyperplasia; and knee osteoarthritis.
The program wanted to encourage the patient-provider relationship, not hinder it, the agency said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Though the DDS Model accepted applications through March of 2017, it was never officially launched, according to Politico.
CMS seems to be shifting away from patient-focused decision-making initiatives.
Last year, the agency canceled another CMMI program, the Shared Decision Making Model, because not enough ACOs were interested. Only Medicare Shared Savings Program and Next Generation ACOs were allowed to take part.
The SDM Model’s goal was to bring a four-step decision-making process into the clinical practices of providers participating in the ACOs.
The model accepted applications through March of 2017, but CMS pulled the plug on the program by November of the same year.
Add the DDS Model to the list of programs CMS has axed under the Trump administration. In 2017, it canceled the mandatory hip fracture and cardiac bundled payment programs, which were scheduled to begin on January 1. Additionally, the agency made changes to the Comprehensive Care for Joint Replacement Model, or CJR. As part of the final rule, CMS cut down the number of mandatory geographic areas participating in CJR from 67 to 34. Participation became voluntary for low-volume and rural hospitals in all 67 regions.
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