HHS named a new $1 billion initiative the Health Care Innovation Challenge to encourage competition among healthcare organizations, but for providers, the real challenge now is to determine what the CMS is looking for in potential applicants.
HHS aims to improve quality through challenge
Announced by HHS Secretary Kathleen Sebelius last week, the latest endeavor from the CMS Center for Medicare and Medicaid Innovation will award funding from the healthcare reform law to projects that test creative ways to deliver better quality medical care and save money. Providers, payers, local governments, community-based organizations and public-private partnerships are eligible to apply and the awards are expected to range from $1 million to as high as $30 million for three years.
A news release heralded the program as part of the Obama administration's We Can't Wait initiative, a series of executive actions aimed at job growth. The name is a political jab at congressional Republicans, who have rejected most of the jobs plan President Barack Obama introduced in September.
According to HHS, the CMS Innovation Center will give priority to projects that hire, train and deploy healthcare workers quickly—although officials last week were not specific on either the number or type of healthcare workers that should be employed. CMS Administrator Dr. Donald Berwick said the agency did not have a target number, but that the need for people in new job roles to meet the needs of better coordinated care “is large."
Dr. Richard Gilfillan, acting director for the Innovation Center, said the applicants will help determine what type of healthcare workers are needed. “We've heard that we've not addressed the healthcare workforce,” Gilfillan said. “People have said, ‘What about training?' and we didn't have that in our initial suite of products that were released,” he said, referring to other Innovation Center efforts, including initiatives such as bundled payments, accountable care organizations and the recent Innovation Advisors program (Nov. 7).
“The healthcare workforce of the future will be different,” he added. “In conjunction with their models, what will the implications of the workforce be?” he said about the needs of potential applicants.
Gilfillan reiterated the theme the Innovation Center wants to hear from applicants—who are expected to submit letters of intent by Dec. 19—about their ideas for ways of delivering better care. “They've got great ideas and this is an opportunity to release that energy and give them energy to have those ideas become supported,” he said.
However, some have said that the program is vague, which leaves prospective applicants with questions as they consider applying for the award money.
“I think it has potential,” said Lisa Grabert, senior associate director for policy at the American Hospital Association. “I think right now it's lacking a bit of detail,” she added. “As more specificity comes out, it will be more telling of how much interest there is in it.”
Grabert also emphasized the importance of proper evaluation. “For good reason, there is a lot of excitement to start these initiatives and roll them out,” Grabert said. “Sometimes measuring how successful you were is an afterthought,” she added. “I don't see a lot of upfront materials of what measures of success will be in place.”
According to Gilfillan, the Innovation Center will host webinars to help potential applicants through the process because many people don't have experience in determining how their ideas will affect the cost of care or improving health. He also commented on the wide range of funding levels.
“We've seen a lot of ideas in a lot of price ranges,” Gilfillan said. “This is a very broad funnel. We want small ideas and big ideas,” he added. “We're going to emphasize: These are opportunities for people to think very hard that they can demonstrate they will have better health, better populations, lower cost. We will tie back the expense to outcomes,” he continued. “We're looking for a positive return on the investment we're making.”
One way the Innovation Center could see a positive return is to invest much of the funding from this initiative in leadership development at healthcare organizations, according to Sandy Reed, vice president and project leader, interim and consulting services at healthcare leadership firm B.E. Smith. Better leaders result in improved customer satisfaction and physician satisfaction, and the ability to retain workers is money well-spent, Reed said.
While most organizations rely on classroom sessions, routine conversations or online coaching to develop leaders, they should consider other approaches, she suggested.
“What we see that is more effective: when you have a seasoned leader working hand-in-hand with the person receiving the training so they are experiencing real-life situations,” Reed said. For instance, employees can learn from experienced leaders during situations in which a staff member is complaining or a patient is unhappy. The experienced leader, Reed said, will “work through the situation in real time with the mentee, which gives real-life experiences that a classroom cannot give.”
When Gilfillan was asked if he thought it would be worthwhile to award funding to innovative projects that focus on leadership development, he echoed his earlier sentiments that this will largely be determined by the applicants themselves.
“Again, what we're looking for is for them to tell us about a care model and what makes the most sense,” Gilfillan said. “And what are the critical workforce issues within that.”
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