CMS Innovation Center Strategy Refresh: Policy Update - McDermott+Consulting

CMS Innovation Center Strategy Refresh: Policy Update

The Innovation Center Releases Its Strategic Vision for the Next Decade

On October 20, 2021, the Centers for Medicare and Medicaid Services (CMS) Innovation Center unveiled its refreshed comprehensive strategy that will inform care transformation in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) in the coming decade. The full strategy document is available here.

Key Takeaways

  • The strategy sets a high-level goal of having all traditional Medicare beneficiaries and most Medicaid beneficiaries in an accountable care relationship by 2030. These relationships are described as arrangements where beneficiaries’ needs are holistically assessed and care is coordinated within a total cost of care system. This is a shift from previous administrations’ strategies, which defined goals around the movement to two-sided risk arrangements, such as the 2019 goal of moving 100% of traditional Medicare payments to two-sided risk alternative payment models (APMs) by 2025.
  • Consistent with the Biden Administration’s overarching equity themes, the strategy aims to embed health equity in every aspect of Innovation Center models, including new approaches to measurement, data collection and sharing, and model development and expansion to include patients from historically underserved populations.
  • The strategy centers on total cost of care models and embraces advanced primary care and affords very little attention to specialty and episodic models. The strategy discusses ways to nest or integrate episodes within accountable care models and ways to reform specialty payment structures as part of the agency’s goal of streamlining the model portfolio.
  • The strategy aims to incorporate a broader universe of partners and participants, including state and Medicaid partners, consumer and beneficiary groups, the Health Care Payment Learning and Action Network (LAN), and private purchasers and payers. In particular, the strategy emphasizes multi-payer alignment to drive care and strengthening relationships across a broad swath of stakeholders and provider partners.