CMS establishes Center for Medicare and Medicaid Innovation

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Image Source: Chicago Alliance of Community Health Centers

The Centers for Medicare & Medicaid Services (CMS) has established the Center for Medicare and Medicaid Innovation. Created by the Patient Protection and Affordable Care Act, the Innovation Center will examine new ways of delivering healthcare and paying healthcare providers.

The Innovation Center will consult stakeholders across the healthcare sector, including hospitals, doctors, consumers, payors, states, employers, advocates, relevant federal agencies and others to obtain input on its operations and build partnerships with those interested in its work, according to CMS.

The organization will test models that include establishing an “open innovation community” and will work with stakeholders to create learning communities that help other providers implement these new care models, CMS stated.

The Innovation Center 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 the overall experience of beneficiaries who are eligible for both Medicare and Medicaid.

The Innovation Center expects to award as much as $1 million in design contracts to as many as 15 state programs for this work.

In addition, CMS announced several initiatives to strengthen primary care and care coordination for patients. Initiatives to test "health home" and "medical home" concepts include:

  • 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 that will include up to approximately 1,200 medical homes.
  • The Federally Qualified Health Center (FQHC) 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 as many as 500 FQHCs, according to CMS.