New Medicare, Medicaid initiative to experiment with ideas

Share this content:

Let the brewing begin! That's how I interpreted this week's launch of the Center for Medicare and Medicaid Innovation. 

I don't know about you, but a center for innovation, to me, conjures up images of a laboratory with white-coated scientists working with steam-spewing beakers. Of course, that's not the kind of center the Centers for Medicare & Medicaid Services has in mind.

It really is more of an ideas laboratory to find ways to improve care and cut costs for the increasingly complex Medicare and Medicaid populations.

“The Innovation Center will be a new, and much needed, driver of innovation aimed at improving health care for Medicare and Medicaid beneficiaries,” Acting Innovation Center Director Dr. Richard Gilfillan said in a statement. “The center will identify and test care models that provide beneficiaries with a seamless care experience, better health and lower costs.”

There are already some ideas percolating from this initiative: A new state plan option will allow patients enrolled in Medicaid with at least two chronic conditions to designate a provider as a “health home” that will help coordinate treatments for the patient, CMS disclosed this week. States that implement this option will receive enhanced financial resources from the federal government to support “health homes” in their Medicaid programs.

Also, states soon will be able to apply for contracts to support development of new care and cost models for dual eligibles, or those eligible for Medicare and Medicaid, CMS said. The Innovation Center expects to award up to $1 million in design contracts to as many as 15 state programs.

This is intriguing work that could have repercussions for long-term care providers. Perhaps the experiment of most interest to nursing home providers at the center will be the development of accountable care organizations (ACOs). No one knows for certain how these will look, but they are likely to involve nursing homes. The basic definition of an ACO is a group of providers, such as physician practices and hospitals, that manage the care of a designated group of people and take responsibility for the costs involved in delivering that care.

Many nursing homes, which increasingly are providing post-acute and subacute care services, want to be part of this next generation of healthcare. Beginning in 2012, the healthcare reform law will allow qualifying healthcare providers to form ACOs and share in any Medicare cost savings they achieve. 

It will be interesting to see what kind of ideas (or concoctions) emerge from this new center. While the projects likely will not involve chemicals and Bunsen burners, my hope is they mix up the delivery of care in our healthcare system in truly productive ways.  

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.