Since its founding in 2010 as a key provision of the Affordable Care Act, the Center for Medicare & Medicaid Innovation (CMMI) has tested over 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs.
On the other hand, many basic lessons learned are lessons unapplied. The United States’ population health outcomes lag behind its highly economically developed peers. Our nation’s health system is still firmly entrenched in the fee-for-service payment system that rewards service volume. This system has delivered lackluster health and health care access, outcomes, efficiency, and affordability.
Anticipating CMMI’s interest in drawing on field leaders for insights and technical advice, the National Academy of Medicine’s (NAM) Leadership Consortium: Collaboration for a Continuously Learning Health System, assembled an expert panel to identify and assess key CMMI opportunities in the context of the current state of health financing and care delivery. Building on the panel’s assessment, the Leadership Consortium also convened two workshops focused on multi-payer alignment on value-based care and collecting data to ensure equity in payment policy to understand the state of the health and health care landscape from multidisciplinary stakeholders.
The resultant Special Publication, Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation, released today, builds on the foundation of these three activities and suggests six key priority actions for CMMI, centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI’s Strategic Refresh.
CMMI has the potential to catalyze the use of science and policy and create the necessary innovation and advancements to transform the nation’s health and health care system. In considering the transformative impact the Center may have, paramount is that these efforts translate into tangible results that impact lives, experiences, and health and health care throughout the nation.
The National Academy of Medicine, established in 1970 as the Institute of Medicine, is an independent organization of eminent professionals from diverse fields, including health and medicine; the natural, social, and behavioral sciences; and beyond. It serves alongside the National Academy of Sciences and the National Academy of Engineering as an adviser to the nation and the international community. Through its domestic and global initiatives, the NAM works to address critical issues in health, medicine, and related policy and inspire positive action across sectors. The NAM collaborates closely with its peer academies and other divisions within the National Academies of Sciences, Engineering, and Medicine.
Download the Special Publication and associated resources: www.nam.edu/leadershipconsortium