The CMS Innovation Center paid $2.6 billion through September to hospitals, doctors and others through nearly two dozen programs that tested new ways to deliver healthcare and pay for it.
But results of those programs—some underway since 2011—including more than 60,000 providers and 2.5 million patients in Medicare, Medicaid and the Children's Health Insurance Program, are largely not yet available, the Innovation Center said in its second report to Congress.
Through September, the center operated 22 initiatives, the report said, and oversaw another 20 programs required by Congress.
The center is required to update Congress every two years on how it plans to spend the $10 billion it received to overhaul the nation's health system. The center was created by a provision in the Patient Protection and Affordable Care Act that seeks to curb U.S. health spending growth and the nation's uneven care quality.
The center's activities include closely watched tests of accountable care and bundled payments, as well as Maryland's attempt to revamp how the state pays hospitals. Some initiatives have just begun, but others, such as the Pioneer Accountable Care Organizations, have operated for more than a year. One effort to develop medical homes in federally qualified health centers ended after three years in October.
Some of the Innovation Center's initiatives have had rocky starts. The Pioneer ACOs launched in 2012 with 32 participants but 13 exited the program in its first two years. Another attempt to create ACOs among kidney-care providers has met with concerns.
However, at least one Innovation Center effort has produced initial findings. Early results for two measures of Pioneer ACO performance—health spending and quality—show mixed performance among ACOs. Pioneer participants saw quality gains from their first to their second year in 28 of 33 measures, while 11 of 23 participants reduced health spending enough to earn bonuses.
The Innovation Center has paid $167.8 million to providers and contractors involved in the Pioneer ACO program, the report said. That amount includes awards made to Pioneer ACOs and payments made for administration and evaluation. In the first two years, Medicare has saved $74 million from Pioneers' cost-control efforts.
The center's most significant investment to date has gone to finance state experimentation under its Health Care Innovation Awards. The awards, which total $1.07 billion, target: care for high-risk and complex patients; treatment for behavioral-health or substance-abuse issues; care for those with chronic conditions; hospital care and efficiency; care coordination; medication management and the patient's role in making healthcare decisions; and redesign of primary care. Other awards seek to reduce the cost of care, develop programs to improve community health and treat those with specialized medical needs.
The report also cited broad improvement in healthcare quality and safety as a potential indicator of success for its Partnership for Patients initiative. That effort, which has contracts that end this month, has been criticized by quality experts for a limited ability to track its effectiveness. The Innovation Center has spent $451 million on the initiative.
Follow Melanie Evans on Twitter: @MHmevans