Center for Medicare and Medicaid Innovation
Establishes within the Centers for Medicare and Medicaid Services (CMS) a Center for Medicare & Medicaid Innovation. The purpose of the Center will be to research, develop, test, and expand innovative payment and delivery arrangements (models) to improve the quality and reduce the cost of care provided to patients in each program. For purposes of testing payment and service delivery models, the Secretary may limit testing of a model to a certain geographic area. Successful models can be expanded nationally. (Successful models are those that improve patient care without increasing spending. Specifies that the Secretary should focus on models that improve the quality of patient care and reduce spending.) Specifies a number of models to be tested but does not limit testing to these models. The bill describes certain models, which could be tested, including models that: (i) support “care coordination for chronically-ill applicable individuals at high risk of hospitalization through a health information technology-enabled provider network that includes care coordinators, a chronic disease registry, and home telehealth technology;” (ii) “facilitate inpatient care, including intensive care, of hospitalized applicable individuals at their local hospital through the use of electronic monitoring by specialists, including intensivists and critical care specialists, based at integrated health systems;” and (iii) utilize particularly “in entities located in medically underserved areas and facilities of the Indian Health Service . . . telehealth services in treating behavioral health issues (such as post-traumatic stress disorder) and stroke and to improve the capacity of non-medical providers and non-specialized medical providers to provide health services for patients with chronic complex conditions.” Also provides additional factors for consideration, including “whether the model utilizes technology, such as electronic health records and patient-based remote monitoring systems, to coordinate care over time and across settings.” The Center would be required to conduct an evaluation of each model tested, including an analysis of (i) the quality of care furnished under the model, including the measurement of patient-level outcomes and patient-centeredness criteria determined appropriate by the Secretary; and (ii) the changes in spending by reason of the model. The scope of the Innovation Center may include the Medicaid and CHIP programs, with the same requirements for testing and evaluation of patient-centered delivery and payment models that have shown evidence of success in Medicaid and CHIP populations as proposed for Medicare. The Center is exempted from budget-neutrality requirements for an initial testing period. Appropriates $5 million from the Treasury not otherwise appropriated for the design, implementation, and evaluation of models for FY 2010; and appropriates $10 billion for Center activities over 10 years. (Sec. 3021)
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