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CMS Innovation Center Launched

Wednesday, November 24, 2010   (0 Comments)
Posted by: Joy Ingram
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The Centers for Medicare and Medicaid Services (CMS) beat the January 1, 2011 deadline and in November announced the opening of the much anticipated Innovation Center, under the temporary leadership of Acting Center Director Richard Gilfillan. It is to be called the Center for Medicare and Medicaid Innovation, or CMMI. What will this Innovation Center mean for community and migrant health centers in Region X?

The purpose of the Center is to identify, support, evaluate and scale models that have demonstrated better patient health outcomes at lower costs. Gilfillan describes successful models as providing beneficiaries with “seamless care experience, better health and lower cost.” The Center will also seek models that establish an “open innovation community” that acts as a clearinghouse of best practices in healthcare innovation. “Learning communities” have also been mentioned as a goal to help providers quickly implement the new care models that are given the green light.

The Innovation Center has described several initiatives to test medical home concepts, including these:

  • The Multi-Payer Advanced Primary Care Practice Demonstration that will include more than 1200 medical homes. Eight states—none in Region X—have been selected to participate.
  • The FQHC Advanced Primary Care Practice Demonstration to test doctors’ teamwork in treating low-income patients at CHCs. Up to 500 FQHCs will be involved in the demonstration.
  • A state Medicaid option that allows Medicaid-enrolled patients with at least two chronic conditions to choose a “health home” that could eventually receive “enhanced financial resources” from the federal government.
  • An invitation to states to apply for contracts to support the development of better care coordination and cost-effectiveness for “dual eligibles” enrolled in both Medicare and Medicaid. Fifteen state programs are the target, with awards up to $1 million in design contracts. Applications will be accepted in December.
  • A second dual-eligiible healthcare integration demonstration to be announced in 2011. It will focus on the roles of both providers and beneficiaries.

CMMI has been funded to the tune of $10 billion for FY 2011-2019 with authority for HHS to expand the duration and scope of successful models. In other words, CMS will not have to seek specific legislative authority to introduce successful models through Medicare, Medicaid and CHIP. Gilfillan called for “rapid deployment of models that work” and “continuous feedback to support rapid learning, adjustment, and evaluation.”

While health information technology is widely recognized as a key to care coordination and healthcare innovation, lack of specific technology will not preclude providers from becoming involved in the initiatives.

The announcement from CMS has been interpreted this way by James Arvantes, President of the American Academy of Family Physicians (AAFP): “The CMMI will test variants of accountable care organizations, PCMH models and payment bundling -- all models of care that reward physicians for value rather than volume.”

Dr. Gilfillan, along with CMS Director Don Berwick, recently hosted a roundtable discussion with various stakeholders representing the health care industry, as well as consumers, states and employers, to discuss the CMMI and its planned activities. Lori Heim, MD. AAFP board chairperson, was in attendance. She stated that CMS was asking for feedback and suggestions for how to best engage stakeholders moving forward. According to the AAFP web site (www.aafp.org), Heim and other stakeholders at the meeting told CMS that the PCMH represents "the direction we need to move in, and the (PCMH) needs to be the basis for any accountable care organizations going forward."

Heim said the meeting also underscored the need for medical homes to involve multiple relevant stakeholders and not just governments or industry. She apparently emphasized the need for rapid feedback and data. "If you are going to manage populations, you are going to have to get the data back (in a timely manner)," Heim said.

The community health center world will be watching for specific guidance outlining opportunities to become involved in this groundbreaking innovation.

 

Sources: www.cms.gov; Arvantes, James. CMS Announces New Innovation Center, Multi-payer Demonstration Project.www.aafp.org, November 19, 2010;  Mosquera, Mary. CMS Innovation Center to Test New Payment Models.www.healtcareitnews.com, November 17, 2010.


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