September 21, 2017

CMS wants to redefine its Innovation Center—and reduce incentives to consolidate

Daily Briefing

    CMS on Wednesday issued a "request for information" (RFI) to solicit new ideas that will revamp CMS' Center for Medicare and Medicaid Innovation (CMMI) and the payment models the center creates, Healthcare IT News reports.

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    CMS Administrator Seema Verma announced the RFI Tuesday in a Wall Street Journal opinion piece. Verma called CMMI "a powerful tool for improving quality and reducing costs." But she said the center's current payment models are too complex and "might have encouraged consolidation within the health care system."

    With the RFI, Verma said the Trump administration seeks to "move away from the assumption that Washington can engineer a more efficient health-care system from afar—that we should specify the processes health care providers are required to follow."

    Verma wrote, "We must shift away from a fee-for-service system that reimburses only on volume and move toward a system that holds providers accountable for outcomes and allows them to innovate. Providers need the freedom to design and offer new approaches to delivering care. Our goal is to increase flexibility by providing more waivers from current requirements." For instance, CMS said it is interested in testing:

    • "Consumer directed" models, which, according to Axios, could involve higher out-of-pocket costs for patients;
    • Physician specialty models;
    • Prescription drug models; and
    • Mental and behavioral health models.

    CMS also said it would like to increase participation in advanced Alternative Payment Models.

    The agency's review will encompass all CMMI models and will seek "to determine what is working and should continue, and what isn't and shouldn't," Verma wrote.

    She said CMS wants to hear from "people on the front lines," noting that there are "[c]linicians, patients, entrepreneurs, state officials, and others [who] are busy designing new and better ways to provide health care." According to Healthcare IT News, CMS will accept comments through Nov. 20 (Verma, Wall Street Journal, 9/19; Morse, Healthcare IT News, 9/20; Herman, Axios, 9/20).

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