The CMS Innovation Center Moved the Needle on Value

We should keep this "national treasure" in case of ACA repeal

As Republicans in Congress threaten to repeal the Affordable Care Act, we keep hearing that value-based care is safe. But how safe can it be if we also dismantle the organization behind CMS’ progress and momentum? The Center for Medicare and Medicaid Innovation (CMMI) was created under the Affordable Care Act and is tasked with developing and testing new payment and service delivery models, assessing results, and working with stakeholders to develop additional models. Free from direct Congressional oversight, the CMMI has been remarkably agile, unique in its ability to quickly make changes based on results and feedback from patients and providers.

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The Case for Mandatory Bundled Payments

Why new HHS secretary Tom Price should not ignore the study in this month's Journal of the American Medical Association

Under president elect Donald Trump, Republicans in Congress are vowing to repeal and replace the Affordable Care Act, effectively slowing down the shift to value-based reimbursement. The Center for Medicare and Medicaid Innovation, created under the ACA, is responsible for much of the industry momentum towards value – and for millions of dollars in annual savings. A new study in the Journal of the American Medical Association analyzed Medicare claims data to reveal that the CMMI’s mandatory bundled payment program for joint replacement, CJR, saved participating hospitals 8% on average and sometimes much more, without sacrificing quality of care. These numbers are significant; if every hospital in America were mandated to participate, the total savings would increase to an estimated $2 billion. Encouraged by CJR’s success, CMS finalized new mandatory bundles for cardiac care in late 2016 and expanded CJR to include additional procedures.

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On the Design of an "Easy-to-Integrate" Care Coordination Platform

Remember that scene in Apollo 13 where they figure out that the air scrubbers are wearing out, and that the astronauts will soon be choking on their own carbon dioxide? Building software for healthcare is a lot like that. That was my face after I settled in and began to understand the complexity of the environments in which our new software would sit. There are dozens, or even hundreds of other applications in a typical hospital system, each of which has its own data, sometimes duplicated, often inconsistent. There are systems tracking patients, care plans, medications, appointments, surgeries, surgeons, nurses, support staff, accounts, billing, and so on. We were going to bring one more application to an already crowded pool party.

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Every Successful Relationship is a Two-Way Street

As was typical, I was mapping out my upcoming week based on my husband’s travel schedule. Most parents will know what I mean by coordinating child care. Who picks up the kids, where to pick them up, when to pick them up, where to take them, when to feed them, what to feed them, when to bathe them – and that’s just your average Tuesday. It becomes that much more complex when I’m sharing those tasks since I work. Juggling work priorities with the critical Mom priorities is a balancing act. In addition to my husband, I collaborate with the nanny, other moms, the kids’ grandparents, Amazon Prime, and many, many others to keep all the balls in the air. So, this past Valentine’s day, I was thankful for all my partners and for the technology that enables seamless two-way communication such as shared to do lists, shared calendars, texts, and emails. Not to mention the aligned incentives in doing a good job, some financial but mostly love!

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