New Innovation Center, Demonstrations

The Centers for Medicare & Medicaid Services (CMS) announced the establishment of the new Center for Medicare and Medicaid Innovation (CMMI or Innovation Center). A provision of the Patient Protection and Affordable Care Act of 2010 (commonly referred to as the Affordable Care Act), the Innovation Center will examine new ways of reducing health care delivery costs without jeopardizing quality of care. CMS also announced the launch of two new demonstration projects that will test “health home” and “medical home” concepts.

CMS says the Innovation Center will consult stakeholders across the health care sector to get input on its operations and to build partnerships. CMS hopes to build an “open innovation community” that serves as an information clearinghouse of best practices in health care innovation.

“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,” said Acting Innovation Center Director, Richard Gilfillan, M.D.

According to a CMS fact sheet, the Innovation Center will promote the use of bundled payments, rather than the current fee-for-service payment method. The organization also will work toward developing new health care delivery models, such as health home, and supporting the advancement of accountable care organizations (ACOs).

New Demonstration Projects

CMS also is launching new initiatives intended to strengthen primary care and better coordinate care for patients.

The Multi-Payer Advanced Primary Care Practice Demonstration. This demonstration project, which will ultimately include up to approximately 1,200 medical homes serving up to one million Medicare beneficiaries, will 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. Eight states have been selected to participate in this demonstration project: Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota.

The Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration. This demonstration project 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 for up to 195,000 people with Medicare.

The Innovation Center also announced an upcoming 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.” The Innovation Center expects to award up to $1 million in design contracts to as many as 15 state programs for this work.

According to CMS, 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.

More information on the Innovation Center and these initiatives is available on the CMMI dedicated website.

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