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When asked why he robbed banks, Willie Sutton, the infamous US bank robber, responded “because that’s where the money is.” This quote is the inspiration for “Sutton’s Law,” which recommends prioritizing those diagnostic tests that are most likely to yield a definitive diagnosis and quickly lead to a treatment recommendation. While Sutton’s Law has been applied to diagnostic testing, this commonsense approach is also applicable to the important policy decision of who should have access to alternative payment models (APMs) for the seriously ill.
The Center for Medicare and Medicaid Innovation (the Innovation Center) recently announced a new demonstration to test an APM for the seriously ill with the goal of improving the quality of care while reducing costs…