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To that end, MedPAC staff member Kate Bloniarz noted during the presentation of the VVP proposal that the total payments in the program "should be capped to be less attractive than joining an [advanced] APM.
Commission member Kathy Buto, former vice president of global health policy at Johnson & Johnson, suggested withholding be increased to perhaps 3%, with providers able to recoup 2% in the VVP and 3% in an APM, to further incentivize APM participation.
Most commissioners expressed support for both the repeal of MIPS and the conceptual framework for the new VVP, although many sought more details, particularly in the handling of specialists.
"I don't know that we want to try to make the VVP do too much, especially when you get into the specialties that are very, very episodic," said commission member Brian DeBusk, PhD, CEO of DeRoyal Industries.
"I would suggest that we try to think about doing that in the context of something that is a little bit, perhaps, not full bore APM, but a VVP for specialists with their own metrics that are not big, gigantic readmissions," she said.
David Nerenz, PhD, of the Henry Ford Health System, said that he had "very serious concerns about the VVP part of this proposal, [and] they are such that if it comes to us as a recommendation in more or less its current form, I will not support it."
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