The Opportunity

The Center for Medicare and Medicaid Innovation (the Innovation Center) is an important new resource for health care providers dedicated to improving how our health care system works. Its mission is to move quickly to identify, test, and spread delivery and payment models to help providers improve care while cutting costs.

The United States is the global leader in developing new ways to prevent, diagnose, manage, and cure illness. Our academic institutions offer the finest education and training available. Our talented physicians, nurses, and clinicians work hard each day to deliver the highest quality care. Many of our hospitals are internationally known and admired. Yet despite having the world’s best doctors and nurses, most advanced medical technology, and finest hospitals, Americans continue to live sicker and die sooner than citizens of many other nations.

Our health care system is full of barriers, roadblocks, and red-tape—ranging from the way we pay for health care services to a lack of usable, reliable information for patients and clinicians alike—that often keep health care professionals from practicing medicine in a collegial, evidence-based, and patient-centered manner. Many doctors, nurses, and other providers have had great ideas, good intentions, and determined efforts, but have been thwarted by disincentives and other obstacles to innovation. The result is a health care system that is often disjointed, inefficient, and costly.

Yet we know improvement is possible. Dedicated clinicians and innovative entrepreneurs around the country have found ways to work with other providers and payers in their local communities to break down barriers and redesign care for the benefit of their patients, themselves, and their communities. For example, large employers and unions are working together to improve the health of their workers by investing in comprehensive primary care, which is decreasing the overall cost of healthcare.

Similarly, some health systems have demonstrated that by keeping people healthy in the first place, providing a coordinated care experience, and striving to get care right every time, they can achieve better outcomes and lower costs for their patients. From their efforts, we know what can and should be done. The current and crucial health care challenge is to bring the best of these approaches to every community in the country.

Through specific transformative programs in the Affordable Care Act and programs launched by the Innovation Center, HHS and Centers for Medicare and Medicaid Services (CMS) are working hard to support physicians, nurses, hospital systems, and others who have accepted the challenge to develop a new, sustainable health care system. It will be a system where providers work with engaged patients and are rewarded for keeping people well, not simply for delivering more services.