CMS Launches Strategy to Drive Health System Transformation
Under a newly refreshed strategy (https://innovation.cms.gov/strategic-direction-whitepaper), the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center is expanding models in the healthcare industry that reduce program costs and improving quality and outcomes for Medicare and Medicaid beneficiaries, the agency announced in an October 2021 white paper.
The CMS Innovation Center was established (https://innovation.cms.gov/strategic-direction-whitepaper) in 2010 to “transition the health system to value-based care” by addressing low quality of care and increased spending in the industry. In its white paper, the center emphasized how measuring progress toward broader health system transformation is critical to achieving its five new objectives for the future:
- Drive accountable care.
- Advance health equity.
- Support innovating.
- Address affordability.
- Partner to achieve system transformation.
“In the past decade, the CMS Innovation Center has launched over 50 model tests [with the goal of transitioning the health system to value-based care]. From 2018–2020, Innovation Center models have reached (https://innovation.cms.gov/data-and-reports/2021/rtc-2020) nearly 28 million patients and over 528,000 healthcare providers and plans,” the Innovation Center said (https://innovation.cms.gov/strategic-direction-whitepaper) in its white paper. However, “only six out of more than 50 models launched generated statistically significant savings to Medicare and to taxpayers” and four met the requirements to expand their duration and scope.
The center’s new direction is based on the lessons learned from reviews of its models and research. Its next steps recognize some of the issues and challenges the health system is facing: partnering with other CMS components and external stakeholders and recognizing and addressing patients’ medical needs.
In the white paper’s conclusion, the center outlined implementation strategies to achieve the vision of a broad health system transformation by 2030.
“As part of achieving the Innovation Center’s renewed vision, its contribution to building a health system of the future that achieves equitable outcomes through high-quality, affordable, person-center care will need to be assessed,” the Innovation Center said (https://innovation.cms.gov/strategic-direction-whitepaper). “Beyond reducing costs and improving quality, success must also be measured by how its models impact CMS programs, patients and families, providers, payers, states, and the broader healthcare system to ensure all benefit from and participate in this vision.”