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CMS will launch stakeholder engagement strategies across the life cycle of models, share model test data with external researches, and leverage existing and new mechanisms to enhance engagement with patients, providers and payers and improve transparency in model design and implementation.
In addition, the latest information about the Innovation Center and details about Innovation Center models can be found on the innovation. Department of Health and Human Services.
Strategic Objective 1: Drive Accountable Care. The National Academy of Medicine reported that high-quality primary care forms the foundation of a high-functioning health system and is key to improving the experience of patients and care teams, as well as population health, and reducing costs.
The goal is for all Medicare beneficiaries with Parts A and B to be in a care relationship with accountability for quality and total cost of care by and the vast majority of Medicaid beneficiaries to have the same. Strategic Objective 2: Advance Health Equity. To do so, all new models will require participants to collect and report the demographic data of their beneficiaries and, as appropriate, data on social needs and determinants of social health.
All new models must also include patients from historically underserved populations and safety net providers, such as community health centers and disproportionate share hospitals. Finally, CMS will identify areas for reducing inequities at the population level, such as avoidable admissions, and set targets for reducing those inequities.
Strategic Objective 3: Support Care Innovations. CMS found that accountable care models, especially those that include total cost of care approaches, will need payment incentives to support the delivery of integrated, equitable person-centered care. To accomplish this goal, CMS will set targets to improve performance of models on patient experience measures, such as health and functional status, or as subset of Consumer Assessment of Healthcare Providers and Systems CAHPS measures that assess health promotion and education, share decision-making and care coordination.
All models will consider or include patient-report outcomes as part of the performance measurement strategy. While national health spending growth slowed between and compared to the previous decade, costs continue to rise at unsustainable rates for both state and federal governments as well as households.
Therefore, making health care affordable is an important consideration to driving broad system transformation. CMS has always had the authority to test payment models through demonstration programs. In prior years, Congressional action was necessary to expand successful demonstration programs into the full Medicare program, which often delayed or blocked their implementation.
Additionally, CMS was often prevented from modifying or ending demonstration models based on early results positive or negative , because the models were specified in law. These funds are not subject to annual appropriations. They are designated for the operation of CMMI and to test and evaluate health care payment models that have the specific goals of lowering program expenditures under Medicare, Medicaid, and CHIP while maintaining or enhancing the quality of care furnished under these programs.
To date, the evidence on Medicare payment and delivery system reforms is mixed. While some CMMI models are meeting and improving upon quality goals, overall net savings to Medicare has been relatively modest, with large variations in results between the major models as well as among the individual programs within each of them. Below are the latest available results for selected models. For further details on these results, see the Kaiser Family Foundation Evidence Link —an online resource with interactive tools for comparing each model based on key features and available evidence on savings and quality.
Two CMMI models have met the statutory criteria to be eligible for expansion by reducing program spending while preserving or enhancing quality. The model concentrated on patient engagement activities for losing weight and making positive dietary choices. The Secretary also certified the Pioneer ACO model for expansion into Medicare based on early savings and quality results. The model was extended an extra year, but to date, the Secretary has not made the Pioneer ACO model a part of the full Medicare program.
Sometimes, depending on the model. For most of the CMMI models, doctors and other providers are required to inform their Medicare patients if they are participating in a CMMI payment model, but it is not clear if their patients are typically aware of their attribution to one, or the implications for their care.
Most beneficiaries in CMMI models are in traditional Medicare and, therefore, retain their right to see any Medicare provider without financial penalty. Beneficiaries in CMMI models can also sign certain forms to prevent the sharing of their health information with other providers.
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Jan 13, · Creates and tests new models in clinical care, integrated care and community health, and disseminates information on these models through CMS, HHS, states, local . WebJan 13, · Creates and tests innovative payment and service delivery models, building collaborative learning networks to facilitate the collection and analysis of innovation, as . Oct 27, · The Innovation Center, established in as part of the Affordable Care Act, began as an initiative to transition the health system to value-based care by developing, .