Advisory Council August 2016 Meeting Presentation: Health Care Innovation Awards

Monday, August 1, 2016

Health Care Innovation Awards

Ellen Blackwell, CMS

Center for Medicare and Medicaid Innovation

• CMS’s Center for Medicare and Medicaid Innovation (Innovation Center)  was established through the Affordable Care Act in 2010
• Its purpose is to test innovative payment and service delivery models to reduce program expenditures …while preserving or enhancing the quality of care for Medicare, Medicaid, and Children’s Health Insurance Program beneficiaries
• The Innovation Center may under some circumstances expand the scope and duration of a model being tested through rulemaking, including the option of testing on a nationwide basis:
  • A model must either reduce spending without reducing the quality of care, or improve the quality of care without increasing spending, and must not deny or limit coverage/provision of benefits
  • These determinations are made based on evaluations performed CMS and the certification of the Agency’s Chief Actuary with respect to spending
  • Example of expansion process with Medicare’s new Diabetes Prevention Program (DPP): http://www.hhs.gov/about/news/2016/03/23/independent-experts-confirm-diabetes-prevention-model-supported-affordable-care-act-saves-money.html
• Website: https://innovation.cms.gov/

HCIA Awards

• CMS’s Health Care Innovation Awards (HCIA) aim to identify and support a broad range of innovative service delivery and payment models that achieve better care, better health and lower costs
  • HCIA Round One Funding Period: July 2012 - June 2015
    • External Evaluation Timeline
    • 1st and 2nd annual reports available
    • 2nd annual reports available at https://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/
    • 3rd Annual Report anticipated release:  Early 2017
    • For those with No Cost Extensions, there will be an addendum to the 3rd Annual Report (up to a year later)
  • HCIA Round Two Funding Period: September 2014 - August 2017
    • External Evaluation Timeline
    • 1st Annual Report anticipated release: Summer 2016
    • 2nd Annual Report anticipated release: Mid-year 2017
    • 3rd Annual Report anticipated release: Mid-year 2018