In partnership with clinicians, patients, entrepreneurs, state officials, and others, the Centers for Medicare & Medicaid Services (CMS) plays a leading role in safeguarding the health of America’s future by providing coverage to over 130 million Americans, more than a third of the population of the United States. Our nation’s elderly and most vulnerable citizens depend on these programs for access to care but both programs face fiscal crises. Medicare’s main trust fund is projected to run out in just eleven years, and Medicaid is the second largest budget item for states on average (behind K-12 education) and is growing rapidly. Improving quality and reducing costs are imperative.
One of the most important goals at CMS is fostering an affordable, accessible healthcare system that puts patients first. Through this informal Request for Information (RFI) the CMS Innovation Center (Innovation Center) is seeking your feedback on a new direction to promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes. The Innovation Center welcomes stakeholder input on the ideas included here, on additional ideas and concepts, and on the future direction of the Innovation Center.
Request for Information Details
While existing partnerships with healthcare providers, clinicians, states, payers and stakeholders have generated important value and lessons, CMS is setting a new direction for the Innovation Center. We will carefully evaluate how models developed consistent with the new directions can complement what we are learning from the existing initiatives. In particular, the Innovation Center is interested in testing models in the following eight focus areas:
- Increased participation in Advanced Alternative Payment Models (APMs);
- Consumer-Directed Care & Market-Based Innovation Models;
- Physician Specialty Models;
- Prescription Drug Models;
- Medicare Advantage (MA) Innovation Models;
- State-Based and Local Innovation, including Medicaid-focused Models;
- Mental and Behavioral Health Models; and
- Program Integrity.
However, the Innovation Center may also test models in other areas.