Officials from the U.S. Centers for Medicare & Medicaid Services (CMS) and its main innovation hub touted a “strategy refresh” on Wednesday.
Among its key pillars, the refresh calls for greater payment and regulatory flexibilities supporting the provision of home- and community-based care.
CMS Administrator Chiquita Brooks-LaSure discussed the strategy reset during a Wednesday afternoon webinar. Brooks-LaSure was joined by CMS Innovation Center Director Liz Fowler, in addition to the center’s chief strategy officer, Purva Rawal.
“My vision for the future of the agency, our programs and the people we serve is straightforward: that CMS serves the public as a trusted partner and steward dedicated to advancing health equity, expanding coverage and improving health outcomes,” Brooks-LaSure said.
Ellen Lukens, group director of the CMS Innovation Center’s policies and programs group, was also on the webinar.
Contextually, the strategy refresh from CMS comes after a thorough review of the innovation center’s 10-year history.
Established in 2010 under the Affordable Care Act, the center’s overarching goal is to help move the U.S. health system toward value-based care across Medicare, Medicaid and the other major government health care programs. From 2018 to 2020 alone, CMS Innovation Center models affected over 528,000 health care providers and plans while also impacting nearly 28 million patients.
“Our vision is straightforward: a health system that achieves equitable outcomes through high-quality, affordable, person-centered care,” Fowler said during the webinar.
Paired with the webinar, CMS provided details of the refresh in a 32-page white paper, also released Wednesday. Driving accountable care, advancing health equity, supporting innovation, addressing affordability and partnering to achieve system transformation are the five key pillars of the refresh, the paper explains.
Moving forward, an innovation center goal for beneficiaries is to steer them toward more accountable care relationships.
“Beneficiaries in accountable care relationships will receive more person-centered, integrated care, which could include support with social determinants of health (SDoH) and greater access to care in the home and community,” the paper notes.
As for providers, CMS wants to make sure they have access to more payment flexibilities that support accountable care, such as telehealth, remote patient monitoring and home-based care, particularly those in total cost of care models.
“There are areas where we know providers will need additional tools to meet people where they are,” Rawal said on the webinar. “So we want to design models that give providers those tools that enable the delivery of integrated, whole-person care in the settings beneficiaries prefer, such as in the home or community.”
Over the last 10 years, just six out of more than 50 models launched by the CMS Innovation Center generated statistically significant savings to Medicare.
Only four of those met requirements to be expanded in duration and scope.
One of the four is the Home Health Value-Based Purchasing (HHVBP) Model, which CMS hopes to expand in 2022. The others are the Pioneer ACO Model, the Medicare Diabetes Prevention Program (MDPP) and the Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model.
“Moving forward, payment and regulatory flexibilities for model participants will be examined that can support the provision of home- or community-based care, especially in models that are moving towards or that encompass total cost of care,” the white paper continues.
Companies featured in this article:
Centers for Medicare & Medicaid Services, CMS Innovation Center
