The Center for Medicare and Medicaid Innovation (CMMI), also known as the CMS Innovation Center, is a division within the Centers for Medicare & Medicaid Services (CMS). Established by the Affordable Care Act in 2010, the CMS Innovation Center's primary mission is to test innovative payment and service delivery models with the goal of reducing costs while preserving or enhancing the quality of care within Medicare, Medicaid, and the Children's Health Insurance Program.
Key Objectives:
- Improve the quality of care. CMMI seeks to develop and evaluate new models of care that improve both health care quality and patient outcomes.
- Lower costs. By innovating how care is delivered and paid for, the center aims to reduce the cost of health care while maintaining or improving care quality.
- Broad impact. Successful models can be expanded and implemented across the broader healthcare system, affecting millions of beneficiaries.
Types of Models and Initiatives:
CMMI tests a variety of models, including, but not limited to:
- Accountable Care Organizations (ACOs): These are groups of doctors, hospitals, and other healthcare providers who come together to provide coordinated, high-quality care to their Medicare patients.
- Bundled payments: This model involves a single, bundled payment for all services related to a treatment or condition, encouraging efficiency and coordination.
- Patient-centered medical homes: A care delivery model where patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it.
- Medicare Advantage innovations: Testing changes within Medicare Advantage plans to promote better care, smarter spending, and healthier people.
Evaluation and Expansion:
CMMI rigorously evaluates the impact of these models. Those that demonstrate success in reducing costs while improving or maintaining quality can be expanded nationwide through CMS rulemaking.
Broader Role:
CMMI plays a crucial role in driving innovation within the American healthcare system, especially in the face of rising healthcare costs and the need for more efficient, value-based care delivery. This innovation system is vital for the continuous evolution of healthcare in the United States, aligning payment models more closely with patient outcomes and cost efficiency.
