CMS innovation center launched 12 projects in first year

Washington -- The CMS Center for Medicare and Medicaid Innovation developed a dozen new initiatives to reform the health care system during its first year of operation.

The Commonwealth Fund, a progressive think tank with offices in New York and Washington, published a report highlighting the center's work over the last year. The report described 12 initiatives, including alternative payment model programs that established patient-centered medical homes, accountable care organizations and mentorship programs.

The Centers for Medicare & Medicaid Services launched the innovation center in November 2010. The health system reform law provided $10 billion over 10 years to support the center's mission of testing payment and service delivery models that aim to reduce spending while maintaining or increasing quality of care.

The innovation center has started to change the way people think about the health care system, said Stuart Guterman, co-author of the study and vice president of payment and system reform at the Commonwealth Fund. Health spending under the current payment system is putting pressure on other sectors of the health care industry. "We need to try new things and take some risks because the alternative is not so pleasant."

Stakeholders have pinned their hopes on testing shared-savings pay models to help fix a health care system that is widely agreed to be on an unsustainable path. Medicare has asked for volunteers to participate in advance payment accountable care organizations and pioneer ACO models -- which will reward groups that provide high quality of care and achieve savings targets, and penalize those who increase spending. The ACO initiatives are set to begin in early 2012.

Three other innovation center projects focus on primary care. They are:

• The comprehensive primary care initiative, which encourages public and private payers to support primary care by, for example, paying monthly patient management fees.
• The federally qualified health center advanced primary care demonstration, which promotes the transformation of 500 health centers into medical homes.
• The multipayer primary care initiative, which tests an all-payer medical home in eight states.

These initiatives will continue to be developed as the innovation center gathers input from physicians and other stakeholders, but Guterman said the center likely will create new projects at the same time. "This process isn't discrete; it's going to be continuous."

The American Medical Association also hailed the first year of the CMS innovation center and said it would continue to work with the center going forward.

"The CMMI is an important entity that supports the testing and development of innovative new payment and delivery models to improve care and lower health care costs," said AMA President Peter W. Carmel, MD. "Physicians have always been problem solvers and innovators in finding the best way to take care of their patients. The CMMI has launched several initiatives that will provide resources for promising physician-led projects that may otherwise lack the resources and infrastructure necessary to get off the ground."