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New CMS unit urged to be flexible, move quickly


By Jennifer Lubell
Posted: June 8, 2010 - 8:00 am ET
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Commonwealth Fund researchers are calling on a new federal organization to be “inclusive and flexible” in developing new payment reforms, and to rapidly disseminate such initiatives if they're found to be successful.

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The Center for Medicare and Medicaid Innovation, which begins full-scale operations as part of the CMS in 2011, will be responsible for developing at least 18 reform models specified under the new health reform law, including patient-centered medical homes; promotion of care coordination through salary-based payment; community-based health teams to support small-practice medical homes; use of health information technology to coordinate care for the chronically ill; and salary-based payment for physicians.

In a new article in Health Affairs, Commonwealth Fund researchers recommended that the new center adopt a flexible approach in which new programs are implemented and continued as long as they demonstrate improvement of quality and value, and achieve desired outcomes.

“This would represent a significant shift from the current process for developing, testing and evaluating new programs, which often is lengthy and cumbersome,” according to the article.

The center should also be open to payment reform approaches led by states or private-sector entities, taking into account geographic differences in healthcare and the environments in which care is provided. It should also include among its pilots a variety of payment models, “with the foremost goal being that payments are tied to high quality, efficient care that is patient-centered,” the researchers recommended.

The center should also be willing to share information with the new Independent Payment Advisory Board, a panel tasked with reducing Medicare spending growth, to ensure that its recommendations to control spending are based on the best available information about ongoing and promising initiatives.

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