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Medicare Innovation Center Sets New Direction

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September 27, 2017

Medicare Innovation Center Sets New Direction

 

The Medicare Innovation Center, which has launched a variety of alternative payment models under the Affordable Care Act—such as bundled payments and certain types of accountable care organizations—is taking a new direction, with greater emphasis on voluntary participation and less regulation. The Centers for Medicare & Medicaid Services (CMS) made the announcement in mid-September and asked for public comments on this approach.

 

CMS said it would design new payment models using such principles as:

  • Greater choice and competition  
  • Voluntary models rather than mandatory
  • Less-burdensome requirements

 

Among the possible steps CMS said it might take:  

  • Make it easier for physicians to participate in Advanced Alternative Payment Models (APMs) under the MACRA Quality Payment Program;
  • Encourage greater transparency on costs and quality to better inform consumer choice among competing health providers;
  • Allow beneficiaries to contract directly with providers who would list prices, offer bundled payments for full episodes of care, and launch preferred provider networks;
  • Encourage specialty physicians to manage a defined population of beneficiaries with complex or chronic medical conditions, including multiple chronic conditions; and
  • Allow greater freedom for Medicare Advantage plans to offer innovative approaches in benefit design and compete for Medicare fee-for-service beneficiaries based on transparency in quality and cost.

 

The agency also said that it will evaluate how payment models established under this new direction can complement what the agency is learning from initiatives already underway.  CMS seeks public comment on these and additional issues outlined in its request for information.  Comments are due November 20, 2017.  Resources to submit comments can be found at https://innovation.cms.gov/initiatives/direction/