The Centers for Medicare & Medicaid Services (CMS) recently held a webinar to introduce a new white paper on the Center for Medicare and Medicaid Innovation’s (the Innovation Center) new strategic direction. Senior staff highlighted lessons learned from the Innovation Center’s first decade and detailed five strategic objectives that will guide future efforts. GNYHA recently met with Innovation Center senior staff to learn more about their priorities and discuss our members’ experiences, including their challenges and barriers while participating in Innovation Center payment models.
Innovation Center staff highlighted five lessons learned:
- A streamlined portfolio of Innovation Center models would reduce complexity, limit overlap, and improve CMS’s ability to scale successful innovations
- A challenge for providers can be accepting downside risk, which often requires infrastructure investments. Better tools—such as actionable data, learning collaboratives, and payment and regulatory flexibilities—should be provided to support delivery system transformation.
- Current model designs may not be conducive to broad provider participation, and future designs should ensure participation from a diverse group of providers. CMS will focus on models that promote broad participation, including mandatory participation and those with multi-payer alignment opportunities.
- The complexity of financial benchmarks has undermined model effectiveness, and future benchmarks should seek to maximize participation, generate sustainable savings, limit spending growth, and motivate continuous improvement
- Future model designs should encourage sustained delivery system transformation that continues after the model ends
The Innovation Center’s objectives in response to the lessons learned include:
- Drive accountable care: increase the number of beneficiaries in care relationships who are accountable for quality and total cost of care
- Advance health equity: embed health equity in every aspect of model design and focus more on underserved populations
- Support care innovations: enable integrated, person-centered care by leveraging actionable data, sharing best practices, encouraging peer-to-peer learning collaboratives, and providing payment and regulatory flexibilities
- Improve access: pursue strategies that focus on affordability, addressing health care prices, and reducing unnecessary or duplicative care
- Leverage partnerships to achieve system transformation: align priorities across CMS and engage stakeholders—including payers, purchasers, providers, states, and beneficiaries—to achieve equitable outcomes and reduce health care costs
The Innovation Center plans to hold listening sessions with various stakeholders over the next three to six months. CMS’s website includes more information and resources on the Innovation Center’s strategic direction. GNYHA will continue to advocate for expanded opportunities for our members.