Lessons For The New CMS Innovation Center From The Medicare Health Support Program

Abstract

The Patient Protection and Affordable Care Act establishes a new Center for Medicare and Medicaid Innovation in the Centers for Medicare and Medicaid Services (CMS). The center is intended to enhance the CMS's role in promoting much-needed improvements in payment and service delivery. Lessons from the Medicare Health Support Program, a chronic care pilot program that ran between 2005 and 2008, illustrate the value of drawing on experience in planning for the center and future pilot programs. The lessons include the importance of strong leadership; collaboration and flexibility to foster innovation; receptivity of beneficiaries to care management; and the need for timely data on patients' status. The lessons also highlight pitfalls to be avoided in planning future pilot programs, such as flawed strategies for selecting populations to target when testing payment and service delivery reforms.

Progress in palliative care in Israel: comparative mapping and next steps

“…There is concern that success of this initiative may be limited by the failure to specifically relate to standards of care, standards of assessment, and quality of care of this new endeavor [44]. …”

“…Other, usually smaller, palliative care services provide their care wherever the patient is, without the option of moving to a dedicated palliative care service bed. Much of the successful dissemination and development of service capacity in the US was due to the funding of the Center to Advance Palliative Care, and the finding by researchers of empirical data consistent with a robust business case allowed its integration to move forward rapidly against the backdrop of spiraling healthcare costs [ 43 , 44 ]. The implementation of the Affordable Care Act of April 2010 is still emerging http://www.healthreform.gov/index1.html , but increased funding for home-based care may improve use of palliative care as well.…”

“…As described above, in order to build on current policy, in July 2009, the Israeli Ministry of Health published a policy directive requiring universal access to palliative care within a few years. There is concern that success of this initiative may be limited by the failure to specifically relate to standards of care, standards of assessment, and quality of care of this new endeavor [ 44 ].…”

An Economic History of Medicare Part C

“…There has not yet been much systematic analysis to show whether MA's disease management, care coordination, and preventive care programs generate better health outcomes than did those in TM. One large demonstration project showed that disease management did not reduce cost in TM, although the initial imbalances between the treatment and the control groups muddied these results (Barr et al 2010; McCall et al 2008).…”

Lessons for Primary Care from the First Ten Years of Medicare Coordinated Care Demonstration Projects

“…These provide historic context to the current market, elucidate those services that have been tried in the past, and provide insights into where care coordination is headed. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] (Note that the terms care management, care coordination, and case management are related, albeit distinct concepts. We included demonstration projects that offered care management fees [the term used in solicitations in the Federal Register].…”