The Centers for Medicare & Medicaid Services promises fewer, more streamlined payment models over the next decade. It laid out this strategic direction for its Innovation Center Wednesday during a webinar.
“We’ve learned that testing almost 50 models simultaneously — many in the same market with the same providers without clear guidance on how savings can be shared — can lead to confusion and complexity,” Liz Fowler, director of CMMI, said. “The Innovation Center will be guided by a cohesive strategy that will guide model development and evaluation and its evolution.“There will be fewer models. This will allow us to ensure that where there is model overlap that it is rational and it does not interfere with model objectives.”
Fowler said going forward, all CMMI models must adhere to a set of pillars that address health equity, integrate CMS shareholders, build on the Affordable Care Act, protect program sustainability and drive innovation. She said existing models that don’t fit that criteria won’t necessarily be scrapped, but might be adjusted.
“They might be modified to better address health equity, social determinants of health, include more Medicaid beneficiaries and have modified financial incentives to achieve the outlined goals,” said Fowler.
CMMI is also expected to give more consideration to models that meet patients where they live, including home and community-based settings.
CMS launched the Innovation Center more than a decade ago as part of the ACA under the Obama administration. CMMI’s goal has been to develop models that would transform the way healthcare is delivered by improving care and reducing costs. Over the last decade, CMMI models have impacted 28 million Medicare and Medicaid beneficiaries and more than 500,000 providers.