The challenge ahead for CMS; from innovation to improving Medicare
As the New Year begins with hopes of new and better things ahead, a critical challenge faces CMS and the millions of Americans in the Medicare program– learning how to harness innovations in care delivery on behalf of Medicare beneficiaries. Each day several million Americans who are ‘higher-risk’ older adults with chronic conditions could be benefitting from a model like HQP’s. Yet, despite its durable effectiveness in a rigorous, long-running, randomized trial, it is not clear how CMS plans to transition a program like HQP’s from promising innovation at a single site within a demonstration, to progressively greater opportunities for replication and dissemination. Though Congress has given it the authority to do so it is unknown how CMS might go about it. While the task is far from easy, it is imperative for the future of Medicare.
This is a truly pivotal question. Discovering new innovative models that are effective, within the many, many demonstrations, projects, and pilots in the current health reform legislation, will do us little good, if when a new approach is found to be beneficial, CMS is unable to find ways to expand its use without significant delay – time being something that neither beneficiaries nor the financial solvency of Medicare can afford to waste. Perhaps the creation of a Center for Medicare and Medicaid Innovation within CMS as described in the Senate health reform legislation will help, but it may not. It might be that greater partnering with providers designing and implementing successful new models, public accountability, transparency, a sense of urgency about moving promising innovations into broader use, and clear objectives for doing so will be needed.
