The Centers for Medicare & Medicaid Services has formally established the new Center for Medicare and Medicaid Innovation.
Created by the Affordable Care Act, the center will examine new ways of delivering healthcare and paying healthcare providers that can save money for Medicare and Medicaid while improving the quality of care.
"For too long, healthcare in the United States has been fragmented – failing to meet patients' basic needs, and leaving both patients and providers frustrated. Payment systems often fail to reward providers for coordinating care and keeping their patients healthy reinforcing this fragmentation," said CMS Administrator Donald Berwick, MD.
"The Innovation Center will be a new and much-needed driver of innovation aimed at improving healthcare for Medicare and Medicaid beneficiaries," said Acting Innovation Center Director Richard Gilfillan, MD. "By working together with innovative and committed providers we can create a system that works better for everyone. We want to identify, validate and scale models that have been effective in achieving better outcomes and improving the quality of care, but may be relatively unknown."
The center will consult with stakeholders across the healthcare sector, including hospitals, doctors, consumers, payers, states, employers, advocates, relevant federal agencies and others, to discuss its operations and build partnerships. The organization will also test models that include establishing an "open innovation community" that serves as an information clearinghouse of best practices in healthcare innovation.
The center will also work with stakeholders to create learning communities that help other providers rapidly implement these new care models, officials said.
In related news, CMS officials announced several new initiatives to strengthen primary care and better coordinate care for patients.
"Primary care that is person-centered, coordinated and seamless – creating a 'health home' – is a foundation upon which a high performing system that delivers health, not just care, needs to be built," Berwick said.
Officials say the new initiatives will test "health home" and "medical home" concepts. Among them:
- Eight states have been selected to participate in a demonstration project to evaluate the effectiveness of doctors and other health professionals across the care system working in a more integrated fashion and receiving more coordinated payment from Medicare, Medicaid and private health plans. Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota will participate in the Multi-Payer Advanced Primary Care Practice Demonstration, which will ultimately include up to approximately 1,200 medical homes serving up to 1 million Medicare beneficiaries.
- The Federally Qualified Health Center Advanced Primary Care Practice Demonstration will test the effectiveness of doctors and other health professionals working in teams to treat low-income patients at community health centers. The demonstration will be conducted by the Innovation Center in up to 500 FQHCs and provide patient-centered, coordinated care to up to 195,000 people with Medicare.
- A new state plan option under which patients enrolled in Medicaid with at least two chronic conditions can designate a provider as a "health home" that would help coordinate treatments for the patient. States that implement this option will receive enhanced financial resources from the federal government to support "health homes" in their Medicaid programs.
The Innovation Center has announced an opportunity for states to apply for contracts to support development of new models aimed at improving care quality, care coordination, cost-effectiveness and overall experience of beneficiaries who are eligible for both Medicare and Medicaid, also known as "dual eligibles." Up to $1 million in design contracts will be awarded to as many as 15 state programs.