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Only one-third of the models analyzed produced substantial savings for the federal government, according to Avalere Health.
Dive Insight:
The CMMI was created by the Affordable Care Act to test new payment and care delivery models in a bid to lower costs and improve quality in government healthcare programs. Most models have focused on Medicare, the major insurance program geared toward older Americans, according to Avalere.
However, contrary to its goal, the agency’s work has driven up federal spending. CMMI’s activities increased direct spending by $5.4 billion, or about 0.1% of the net spending on Medicare, between 2011 and 2020, according to a report from the Congressional Budget Office. And although models can be expanded nationwide if they’re shown to lower costs without hurting care quality, improve quality without increasing spending, or both, only four out of 50 models have been selected for expansion.