If you believe we need new approaches to pay for and deliver health care — and you have some good ideas — Washington wants to hear from you.
CMS recently put forth a Request For Information, asking for suggestions to foster a more affordable and accessible health care system that puts patients first. As the Quality Institute prepares its response, I am eager for your perspective. The deadline is November 20, so please email me directly at lschwimmer@njhcqi.org very soon.
The RFI comes from the CMS Innovation Center, which was created under the ACA to promote new approaches and payment reforms to improve quality and reduce costs. After the 2016 election, those of us who support the Innovation Center were worried about its future.
I was pleased to see that the center will continue and that the RFI calls for greater local input. CMS Administrator Seema Verma said all models are being analyzed to determine “what is working and should continue, and what isn’t and shouldn’t.”
The Innovation Center is interested in testing models in at least these eight focus areas: advanced alternative payment models for more clinicians; consumer directed care through greater price and quality transparency and even consumers sharing in savings; physician specialty models, including a specialty medical home for complex patients/conditions; innovative prescription drug purchasing models for Medicare Part B and Medicaid; Medicare Advantage Innovations to incorporate other options and incentives to reduce costs and align incentives; state-based innovations including Medicaid focused models (including Strong Start for pregnant women); Mental health and Substance Abuse models; and program integrity innovations to reduce fraud, waste and abuse.
Recommendations that address these eight topics are covered extensively in the Quality Institute’s Medicaid 2.0 Blueprint for the Future. I’ve also written in this column about many of your successful innovations right here in the Garden State that should be supported by the Innovation Center. We plan to answer the call for local solutions.
We’re currently working on exciting innovations to improve care. We’re creating Alternative Payment Models for Medicaid; designing an Episode of Care for improved maternity outcomes; and a Patient Centered Medical Home for complex, high needs children.
As I pull my thoughts together to respond to the RFI, I would love to hear from you. It seems clear the move away from fee-for-service and toward value-based care will continue. And no matter what the future brings, I believe both sides of the political aisle will continue to support the Triple Aim: better care, smarter spending, and healthier people.