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Last Wednesday, the venerable New England Journal of Medicine published “CMS Innovation Center at 10 Years — Progress and Lessons Learned” authored by Brad Smith, the Director of the Center for Medicare and Medicaid Innovation. After 10 years and $20 billion, he concluded that “value-based care will achieve its promise only if the federal government and stakeholders take more aggressive action to prioritize models that can truly achieve savings and improve quality.” In a view shared by many industry observers, the efforts of CMMI have fallen short.
BACKGROUND
CMMI was created by the Patient Protection and Affordable Care Act (2010) to “test innovative payment and delivery system models that show important promise for maintaining or improving the quality of care in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), while slowing the rate of growth in program costs”. Its funding came from an appropriation of $10 billion for the years 2011 through 2019 in the ACA, and another $10 billion each decade thereafter. Its operating budget is $1.4 billion this year.