Archive for Center for Medicare and Medicaid Innovation

 

Comprehensive Primary Care Initiative Showing Mixed Results

The federal Comprehensive Primary Care Initiative is achieving some of its objectives but not others, according to a new Health Affairs study.

The program, according to the Center for Medicare and Medicaid Innovation, seeks to use five means – risk-stratified care management, improved access to and continuity of care, planned care for chronic conditions and preventive care, patient and caregiver engagement, and coordination of care – to “achieve improved care, better health for populations, and lower costs, and can inform future Medicare and Medicaid policy.”

According to the Health Affairs study, the program is achieving some of these objectives.

CPC practices reported improvements in primary care delivery, including care management for high-risk patients, enhanced access, and improved coordination of care transitions. The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices.

But it is not achieving all of its goals.  It did not, for example,

 … reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures.

Learn more about the study, its findings, and its implications in the Health Affairs report “The Comprehensive Primary …

CMS Announces Drive to Reduce Paperwork

The Centers for Medicare & Medicaid Services is launching a new “Meaningful Measures” initiative that will seek to reduce the regulatory burden on health care providers.

According to a CMS news release, Meaningful Measures

…will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes.  The agency aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes..

In a speech at the Health Care Payment Learning and Action Network, CMS administrator Seema Verma explained that this project will include moving the Center for Medicare and Medicaid Innovation in a new direction that promotes greater flexibility and patient engagement and implementing the Medicare Access and CHIP Reauthorization Act (MACRA) in ways that minimize the burden and cost of complying with the law’s requirements.

To learn more about this new CMS initiative, see this CMS news release or go here to read Ms. Verma’s remarks.…

CMS to Consider Model Behavioral Health Payment and Delivery Program

The Center for Medicare and Medicaid Innovation has invited interested parties to weigh in on the possibility of creating a new Medicare model program for behavioral health care delivery and payment.

According to a notice published in the Federal Register,

The Innovation Center is interested in designing a potential payment or service delivery model to improve health care quality and access, while lowering the cost of care for Medicare, Medicaid, or CHIP beneficiaries with behavioral health conditions. The model may include participation by other payers, qualify as an Advanced Alternative Payment Model (APM), improve health care provider participation in telehealth services, and address the needs of beneficiaries with deficits in care in the following potential areas leading to poor clinical outcomes or potentially avoidable expenditures: (1) Substance use disorders; (2) mental disorders in the presence of co-occurring conditions; (3) Alzheimer’s disease and related dementias; and/or (4) behavioral health workforce challenges.

The agency is hosting a public meeting at its headquarters in Baltimore in September to solicit ideas.

Learn more about the concept and the agency’s intentions in this Federal Register notice.…

Group Seeks Preservation, Reform of Federal Innovation Efforts

A coalition of 35 patient, physician, and hospital groups has written to new Secretary of Health and Human Services Tom Price and asked him to continue the federal government’s exploration of new ways to deliver and pay for Medicare services but to seek certain improvements in how those efforts are undertaken.

The coalition Healthcare Leaders for Accountable Innovation in Medicare asked Secretary Price for a reformed Center for Medicare and Medicaid Innovation so that it operates with

… appropriately-scaled, time-limited demonstration projects, greater transparency, improved data-sharing, and broader collaboration with the private sector.

The coalition also called for CMMI to operate under six guiding principles:

  • foster strong, scientifically valid testing prior to expansion
  • respect Congress’s role in making health policy changes
  • consistently provide transparency and meaningful stakeholder engagement
  • improve data sharing from CMMI testing
  • strengthen beneficiary safeguards
  • collaborate with the private sector

Read the coalition’s entire letter, including a list of the group’s members, here on the web site of the Healthcare Leadership Council.…

Feds Launch Medicare-Medicaid ACO Model

The Center for Medicare and Medicaid Innovation has announced a new Medicare-Medicaid Accountable Care Organization Model that it says

…is focused on improving quality of care and reducing costs for Medicare-Medicaid enrollees. The MMACO Model builds on the Medicare Shared Savings Program (Shared Savings Program), in which groups of providers take on accountability for the Medicare costs and quality of care for Medicare patients. Through the Model, CMS will partner with interested states to offer new and existing Shared Savings Program ACOs the opportunity to take on accountability for the Medicaid costs for their assigned Medicare-Medicaid enrollees.

In this new model, the Innovation Center

… seeks to encourage participation from safety-net providers in Alternative Payment Models. Medicare-Medicaid ACOs that qualify as “Safety-Net ACOs” will be eligible to receive pre-payment of Medicare shared savings to support the ACO’s investment in care coordination infrastructure.

The Innovation Center envisions pursuing such undertakings with six states, which will be chosen on a competitive basis.

Learn more about the Medicare-Medicaid Accountable Care Organization model here, on the Innovation Center’s web site.…