“We are asking people to be more specific in their payment model going forward, and that is different than the way we handled this the first time around,” Dr. Richard Gilfillan, director of the CMS Innovation Center told reporters during a conference call Wednesday. A CMS spokesman confirmed that the average amount of an award in the first round was about $8.4 million. Gilfillan said his office has not predicted the typical amount of an individual award in round two. As he explained, the award funding is typically for a three-year performance period.
“We're looking for a payment model in that three-year period,” Gilfillan said. “It could be in the first year or subsequent years.”
Last year, the CMS selected 107 awardees from nearly 3,000 applications in round one, which was announced in November 2011. Gilfillan said the agency spent about $900 million on that first go-around. Those operations have started, and during the call, HHS Secretary Kathleen Sebelius mentioned a few success stories, including the University of Miami, which she said transformed school-based health clinics into medical homes to improve care for children. Gilfillan said his office does not have estimates on how much has been saved through those innovations.
The CMS Innovation Center has come under fire from congressional Republicans who strongly oppose the 2010 law and question the center's effectiveness. At a Senate Finance Committee hearing in March, Sen. Orrin Hatch (R-Utah), the panel's ranking member, said he thought the Innovation Center was taking on too many initiatives and would do better to concentrate on a select few. He also cited a Government Accountability Office report that found nearly half of the CMS Innovation Center's staff of more than 184 people are paid at the highest levels of the federal pay scale, which he said is different from other areas within the CMS.
In fielding questions from reporters, Gilfillan said in every initiative the Innovation Center has tested, the center has evaluated how a particular model will improve outcomes and patient experience while also lowering costs. “We continue to be focused on that in this round,” he added.
Applicants—including provider groups, payers, health systems, states, local governments, for-profit entities and other organizations—must first submit a letter of intent for round two, which the CMS will accept between June 1 and June 28. The agency will accept applications between June 14 and Aug. 15, and the CMS expects to announce the awardees at the start of next year, according to Gilfillan, who also said the Innovation Center does not have plans for a third round of awards.
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