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The Center for Medicare and Medicaid Innovation (CMMI) has announced a refreshed strategy to promote evidence-based prevention, empower beneficiaries to achieve their health goals, and promote competition and choice in health care markets. Value-based payment (VBP) can advance that vision, but only if CMMI dramatically amplifies the will among provider organizations to fully commit to generating health and value.
CMMI was conceived of as the research and development arm of the Centers for Medicare and Medicaid Services (CMS) in 2010, empowered with a generous budget, exemption from oversight requirements such as judicial review, and authority to waive laws and regulations in building and testing innovative care delivery and payment models.
Despite sponsoring many VBP models, CMMI has not reached its full potential, evidenced by both the paucity of models meeting statutory criteria for scaling, and significant opportunities to lower costs and improve health remaining on the table.
We believe that a fundamental obstacle to system change is a lack of participation from leadership at major health care organizations. In the absence of tight alignment between the societal goal of improving value and those leaders’ business strategies, provider organizations will favor the status quo.