As a part of CMS’ goal to continue shifting providers from fee for service (FFS), the Centers for Medicare and Medicaid Innovation Center (CMMI) recently released its latest value-based payment model: Direct Contracting. CMMI is also preparing to sunset the Next Generation Accountable Care Organization (NGACO) model at the end of 2020.
Full Answer
What is the Center for Medicare and Medicaid Innovation?
Created by the Affordable Care Act, the Center for Medicare and Medicaid Innovation aims to explore innovations in health care delivery and payment that will enhance the quality of care for Medicare and Medicaid beneficiaries, improve the health of the population, and lower costs through improvement.
How many primary care practices does the Innovation Center partner with?
Through these programs, CMS and the Innovation Center will, by 2012, be a core partner in over 1,500 patient-centered primary care practices that will provide integrated, coordinated care to millions of Medicare and Medicaid beneficiaries, and we anticipate that millions of others who will receive their care in these systems will also benefit.
Why should I join the CMS Innovation Center?
These provide opportunities to learn about current programs, upcoming events, and initiatives, as well as to ask questions and offer feedback. The CMS Innovation Center contributes reports and datasets to the community of health care innovators, data researchers, and policy analysts.
What's new at the Innovation Center?
The Innovation Center also announced an upcoming opportunity for demonstration projects that will examine programs that fully integrate care for individuals who are eligible for both Medicare and Medicaid (i.e., dual eligibles).
Is CMS Centers for Medicare and Medicaid Services Legitimate?
The Centers for Medicare & Medicaid Services (CMS) is the agency within the U.S. Department of Health and Human Services (HHS) that administers the nation's major healthcare programs.
What are the innovation models used today by the Center for Medicare and Medicaid Innovation?
Many of these models are in Medicare, including accountable care organizations (ACOs), bundled payment models, and medical homes models. Combined, these three types of models in Medicare are located in all 50 states and the District of Columbia (Figure 1). CMMI is also testing payment models in Medicaid and CHIP.
What is the CMS Innovation Center?
The Centers for Medicare & Medicaid Services (CMS) Innovation Center, also known as “CMMI,” develops and tests new healthcare payment and service delivery models to: Improve patient care. Lower costs. Better align payment systems to promote patient-centered practices.
What is one innovation that was established through Medicare?
Since its introduction in 1965, Medicare has caused a dramatic expansion in hospital infra- structure, increased medical device patenting, and led to the diffusion of imaging technologies.
What is the purpose of the Center for Medicare and Medicaid Innovation CMI which was created by the ACA as a new center within CMS?
Created by the Affordable Care Act, the Center for Medicare and Medicaid Innovation aims to explore innovations in health care delivery and payment that will enhance the quality of care for Medicare and Medicaid beneficiaries, improve the health of the population, and lower costs through improvement.
Who created the Center for Medicare and Medicaid Innovation?
The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.
Why did states sue the federal government over the passage of the Affordable Care Act?
Why did states sue the federal government over the passage of the Affordable Care Act? a. States questioned the constitutionality of requiring individuals to purchase healthcare insurance.
Why was CMS created?
The Centers for Medicare and Medicaid Services (CMS) was created to administer oversight of the Medicare Program and the federal portion of the Medicaid Program.
What is the role of CMS?
The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace.
What did Congress create with Medicare and Medicaid?
On July 30, 1965, President Lyndon B. Johnson signed the Medicare and Medicaid Act, also known as the Social Security Amendments of 1965, into law. It established Medicare, a health insurance program for the elderly, and Medicaid, a health insurance program for people with limited income.
How many categories of initiatives are listed in the CMS Innovation Center?
Our Innovation Models are organized into seven categories.
What is Medicare CMMI model?
The Center for Medicare and Medicaid Innovation (CMMI) supports the development and testing of innovative payment and delivery models. The aim of the Innovation Center is to achieve better care for patients, better health for communities, and lower costs through improvement of our health care system.
Roadmap for Achieving the Vision: Strategic Objectives, Measuring Progress and Next Steps
The white paper summarizes the overarching goal for the Innovation Center’s next decade: the “health system must recognize and meet people’s medical needs by considering their preferences, values, and circumstances, should strive to keep people healthy and independent, and help providers coordinate care seamlessly and holistically across settings in a manner that puts people at the center of their own care.” To this end, the Innovation Center promises to work more closely with external stakeholders and providers most directly affected by the models in order to facilitate a more intentional focus on addressing health disparities and ensuring equitable access, quality, and outcomes.
CMS Innovation Center Strategy – Moving to Implementation
The Innovation Center outlined a proposed timeline to take place to implement its mission to drive value-based payment and transformation across the health system.
Background
The CMMI—which was established with the passage of the ACA—provides a critical framework for addressing rising health care costs.
Trump administration rollback of previous CMMI initiatives
The Obama administration was ambitious in its efforts to study the effects of different payment and delivery reforms. It even planned to test different ways to reduce drug costs under Medicare Part B; however, this program was not ultimately implemented.
New CMMI proposals under the Trump administration
In September 2017, the CMMI released a request for information (RFI) letter titled “Innovation Center New Direction,” requesting policy feedback under the guiding principles of “choice and competition in the market” and “provider choice and incentives.” 23 CMS Administrator Seema Verma published an accompanying op-ed in The Wall Street Journal titled “Medicare and Medicaid Need Innovation,” in which she echoed this desire to focus on market competition and reducing provider requirements.
Conclusion
Given rising health care costs, the need for the CMMI remains as urgent as ever. So far, Trump officials have appeared to pay relatively little attention to the CMMI—and when they have, they have primarily viewed it as a vehicle for ideological reforms to Medicare that could leave patients worse off.
Endnotes
John Gregory, “Adam Boehler officially named new CMMI director,” HealthExec, April 6, 2018, available at http://www.healthexec.com/topics/leadership/adam-boehler-officially-named-new-cmmi-director.
The CMS Innovation Center
The Center for Medicare & Medicaid Innovation (the Innovation Center) with CMS supports the development and testing of innovative health care payment and service delivery models.
Share Your Ideas
We're seeking your ideas to help shape the development of future payment and service delivery models.
Webinars & Forums
The CMS Innovation Center offers webinars and forums about its programs. These provide opportunities to learn about current programs, upcoming events, and initiatives, as well as to ask questions and offer feedback.
Data & Reports
The CMS Innovation Center contributes reports and datasets to the community of health care innovators, data researchers, and policy analysts.