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Nov 16

Written by: Mark Blum
11/16/2010 2:57 PM 

Today, the Obama Administration put into place two building blocks of what could become a coherent strategy for reining in growth in health costs and improving care quality for all Americans.  

First, the Centers for Medicare & Medicaid Services (CMS) formally launched the new Center for Medicare and Medicaid Innovation (Innovation Center today. The Innovation Center was created by the Patient Protection and Affordable Care Act (ACA).

Dr. Don Berwick, MD, the CMS Administrator writes: “The ultimate goal of the Innovation Center is to explore new approaches to the way we pay for and deliver care to patients so that we have better results both in terms of the quality of care and the affordability of coverage.”

The key to the Innovation Center’s success is moving quickly from exploration to implementation, Substantial evidence has accumulated, already, regarding specific innovations in care delivery and provider payment alternatives that demonstrably increase care quality and reduce cost. Too frequently, CMS demonstration projects have been places where good ideas are buried and die.  To fulfill its promise, the new Innovation Center must become a facilitator for expediting transformation of successful innovations to broad implementation in the health system. 

Don Berwick’s leadership at CMS increases the prospects that this could happen.  It’s worth taking a look at the new website CMS has launched in conjunction with its new Innovation Center: http://www.innovations.cms.gov/

CMS moved a second transformational building block into place today with its launch of “A new [ACA-created] State plan option under which patients enrolled in Medicaid with at least two chronic conditions can designate a provider as a “health home” that would help coordinate treatments for the patient.”

If states take advantage of this program, it can become an important step toward creating a continuum of seamless delivery of high-quality, team-based coordinated care for low-income workers who will transition frequently between Medicaid and federally subsidized care received in a state health exchange insurance plan.

Implementation of coordinated Medicaid health home care delivery will contain cost growth and improve care quality.  But here’s an additional news flash:  The Medicaid health home plan option can provide states with substantial dollar increases in the federal share of support to state Medicaid programs. Specifically, the Patient Protection and Affordable Care Act will increase federal matching dollars for current Medicaid recipients from current levels to 90% for eight quarters after state programs are launched. 

The general problem with ACA is the absence of a coherent federal strategy for containing cost growth.  Important building blocks like these are dispersed in a rather unconnected way throughout the reform law.  Nonetheless, these are important building blocks.  They should not be taken for granted.   If the new Congress remains gridlocked in a struggle for finger-pointing position in the 2012 election, it will be up to the states to seize the opportunities new ACA building blocks like these provide for creating coherent statewide strategies to improve care quality and contain cost growth. 

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