Medicare agency launches innovation center, announces new demonstrations

Federal officials on Tuesday launched a new innovation center created by the health reform law that aims to fulfill the triple goal of improving individual care, coordination between providers and prevention.

"For too long, health care in the United States has been fragmented - failing to meet patients' basic needs, and leaving both patients and providers frustrated," Donald Berwick, the administrator of the Centers for Medicare and Medicaid Services (CMS), said in a statement announcing the center. "The Innovation Center will help change this trend by identifying, supporting, and evaluating models of care that both improve the quality of care patients receive and lower costs."

The innovation center's acting director, Richard Gilfillan, added that the center aims to improve the care of Medicare and Medicaid patients alike by working to "identify, validate, and scale models that have been effective in achieving better outcomes and improving the quality of care."

CMS launched the center on Tuesday with a stakeholder meeting including representatives for the health care industry, consumers, states and employers. The goal is to create public-private partnerships, Berwick said, and the innovation center will consult with stakeholders every step of the way and create an "open innovation community" to serve as an information clearinghouse of best practices.

A wide array of stakeholders immediately applauded the announcement. American Medical Association President Cecil Wilson, who was on a CMS call with reporters, applauded the partnership aspect.

But "for the models to succeed," he warned lawmakers, "it is crucial that Congress fix the broken Medicare physician payment system" and prevent a 23 percent cut in physician rates next month that could lead to an exodus of doctors out of the program.

Consumer advocate Debra Ness of the National Partnership for Women and Families also applauded the news.

"For those of us who are working on better coordination, better care and better outcomes for patients," she said, "today’s launch of the Innovation Center is good news indeed. It will help us realize the promise of reform."

The launch was accompanied by the announcement of four new initiatives:

• Eight states have been selected to participate in an evaluation of medical professionals working in a more integrated fashion and receiving more coordinated payment from Medicare, Medicaid and private health plans. They are Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota;

• Another demonstration will test the effectiveness of doctors and other health professionals working in teams to treat low-income patients at community health centers;

• A new state plan option will let Medicaid enrollees designate a provider as a 'health home' that would help coordinate their treatment; and

• States will soon get a chance to apply for contracts to support development of new models aimed at improving care quality, care coordination, cost-effectiveness, and overall experience of beneficiaries who are eligible for both Medicare and Medicaid, also known as 'dual eligibles'.  The Innovation Center expects to award up to $1 million in design contracts to as many as 15 state programs for this work.