Equity and access are central to the vision of the Center for Medicare and Medicaid Innovation (CMMI), agency leaders said during a webinar Wednesday.
“My vision for the future of the agency, our programs, and the people we serve is straightforward. That CMS serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes,” said CMS Administrator Chiquita Brooks-LaSure.
The center’s latest white paper highlights this vision, drawing on lessons learned over the last decade, said Elizabeth Fowler, PhD, JD, deputy administrator and director of CMMI.
The five objectives guiding the agency’s vision consist of driving accountable care; advancing health equity; supporting care innovations; improving access by addressing affordability; and partnering to achieve systems transformation.
“The full diversity of beneficiaries in Medicare and Medicaid is not reflected in many models,” Fowler acknowledged. “So we’ve gone back and are thinking through how to design models to target and increase participation among providers that care for underserved populations and embed equity in every phase of the model development process.”
Brooks-LaSure stressed the importance of ensuring that all of the programs that CMS oversees operate in ways that reduce health disparities. As an example, she pointed to CMS’s recent approval of Colorado’s essential health benefit benchmark plan, which will allow the state to require individual and small group market insurers to provide access to a broader range of services for transgender people.
In regard to accountable care, Fowler said that one of CMMI’s longstanding goals has been to increase the number of providers who practice value-based care, holding themselves accountable for patients’ costs and for improving their health. “This requires increasing beneficiary access to advanced primary care and ACOs [accountable care organizations],” she noted.
Access issues are also of critical importance, said Brooks-LaSure, applauding President Biden’s decision to open a Special Enrollment Period in the healthcare marketplace, which prompted 2.8 million Americans to enroll in healthcare coverage.
CMS is continuing to work with states to expand Medicaid coverage and has strengthened its efforts to help contain premiums and other healthcare costs in the Medicare Savings Program, she added.
For providers looking to experiment with new care delivery approaches, Fowler and Ellen Lukens, MPH, group director of the Policy & Programs Group at CMMI, noted that this is an area where the agency “can do more.”
“We’ve heard from many of you that our models are too burdensome and complex and overlapping models create substantial confusion. We hear you,” Lukens said. Looking ahead, the center is committed to finding a more cohesive way of fitting these models together, and it will work to ensure that the parameters of the models are “transparent and easily understood.”
CMMI is also working to expand the level of support to model participants by giving them access to more actionable data, learning collaboratives, and more regulatory and payment flexibility.
As for criticism the agency has received regarding financial benchmarks, Lukens said it’s clear “that historically complex financial benchmarks have undermined the effectiveness of our models. We need to set benchmarks in the future that balance encouraging participation, while sustainably generating savings.”
“This will require us to improve testing and analysis of benchmarks and risk adjustment methodologies, prior to model launch,” she added.
Asked whether the agency plans to end any of its models early as part of its new strategy, Fowler explained that none of the models would be cut short; however, the five strategic objectives laid out in the agency’s vision for CMMI “will guide revisions to existing models, as well as consideration of future models.”
The agency intends to continue the conversation around its strategic plan through listening sessions and by working with the Health Care Payment Learning & Action Network.
Source: MedicalNewsToday.com
