CMS Innovation Center Highlights Objectives Pertaining to Health System Transformation
On Wednesday, October 20, the Centers for Medicare & Medicaid Services (CMS) hosted a webinar that detailed the Centers for Medicare and Medicaid Innovation (CMMI) strategy moving forward. In conjunction with the webinar, CMMI released a white paper, Innovation Center Strategy Refresh, that outlined its goals moving forward. CMMI’s purpose remains the creation of innovative payment and service delivery models. These innovations are being developed in an effort to reduce expenditures and improve upon the quality of care. CMMI Director Liz Fowler and other officials stressed that CMMI will focus on health equity moving forward. They are looking to expand models that serve the underserved populations and ensure that virtually all clinicians and Medicare/Medicaid beneficiaries are under a value-based system by 2030.
CMMI officials outlined five primary objectives for the next decade. They are:
- Drive accountable care
- Advance health equity
- Support innovation
- Address affordability
- Partner to achieve system transformation.
The first objective aims to increase the number of beneficiaries in a care relationship with accountability focused on quality as well as the total cost of care. For the second objective, CMMI wants to embed health equity in every aspect of each model. This objective also aims to increase focus on underserved populations. The third objective aims to leverage numerous supports that enable integrated, person-centered care. The aim of the fourth objective is to address prices of health care and reduce care that is considered duplicative or unnecessary. Finally, the fifth objective aims to align policies and priorities throughout CMS. This will engage payers, purchasers, states, and other beneficiaries to improve health-care costs and outcomes.
Alternative payment models (APMs) are tested by CMS to reward providers for care that is cost-efficient and top quality. CMS plans to work on new models that will collect and integrate patient and provider perspectives. New models will make multi-payer alignment available by 2030, when applicable. Current models will not be ended earlier than anticipated but moving forward there eventually will be fewer models. The objectives described above are aimed to help refresh current models and shape future ones. CMS plans to improve experience with models by addressing overlaps, simplifying requirements, and reducing the administrative burden. Parameters, requirements, and other critical information for each model will be made transparent and written in a manner that is easily understood.
During the 45-minute presentation, CMMI officials did not mention post-acute and long-term care (PALTC)-focused models, although they did discuss expanding the scope of all models to cover more clinicians and beneficiaries. The white paper makes little mention of this sector as well only stating that CMMI models have helped reduce rehospitalizations from SNFs without reducing quality of care.
The Society has had ongoing conversations with CMMI about the development of value-based models that provide opportunities for PALTC-based clinicians to drive the models and participate in an Advanced APM program under the Quality Payment Program (QPP).
The recent appointment of Walter Lin, MD, MBA, to the Payment Model Technical Advisory Committee (PTAC) should provide a bigger voice for PALTC in the development of value-based models. Dr. Lin has served as AMDA’s American Medical Association delegate as well as a member of the Public Policy Steering Committee.
The entire white paper is available here.