Eight years into its existence, CMS' Center for Medicare and Medicaid Innovation has recommended further development of only two of the 37 models the center has created, with testing completed on 10 of them, according to a new report by the U.S. Government Accountability Office.
The Affordable Care Act set aside $10 billion for the Innovation Center's activities for fiscal 2011 through 2019 and $10 billion per decade beginning in fiscal 2020.
By Sept. 30, 2016, the last period for which data are available, $5.6 billion of its initial $10 billion appropriation had been spent.
The two models that the Innovation Center suggested be extended are Pioneer ACOs and a diabetes prevention program under which beneficiaries are encourage to make lifestyle changes in order to reduce the risk of Type 2 diabetes.
The report is silent as to what fault the agency found with the other 35 models. Generally, to be candidates for continuation models must produce savings and maintain or improve quality of care.
A CMS spokesman did not immediately return a request for comment.
Since the start of the Trump administration, the CMS has canceled at least four models. The reasons have ranged from concerns about burden on providers, lack of interest from stakeholders and poor design.
The junked experiments include: the Direct Decision Support Model, Shared Decision-Making Model, the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model.
The CMS is now reading through thousands of comments as to what model types it should pursue.
It announced earlier this week it is considering launching a direct contracting model under which it would pre-pay practices a certain amount of money to care for beneficiaries in exchange for bringing costs down for participating seniors.
