Image of CMS Innovation Director Liz Fowler; Image credit: CMS
CMS Innovation Director Liz Fowler; Image credit: CMS

The Centers for Medicare & Medicaid Services has proposed a radical, 10-year overhaul to its care delivery programs that could have a major impact on the long-term care sector. 

The agency’s aim is to get every Medicare and most Medicaid beneficiaries into an affordable care plan by 2030, using a model created by its Innovation Center. The idea is to reduce fragmentation in its insurance and social welfare programs, and to improve quality, equity and accountability for the cost of care, according to a strategic statement released this month.

The model’s focus will be on “payments based on value to the patient instead of the volume of services, and delivering person-centered care that meets people where they are,” the agency said. 

“We also want our models to be simpler and easier to participate in with less administrative burden,” Center for Medicare and Medicaid Innovation Director Liz Fowler said during an Oct. 20 webinar, as reported by Healthcare Dive.

The accountable care model is familiar to many nursing home operators and residents. Fully a quarter of residents are in some way linked to an accountable care organization, according to a 2019 study from Dartmouth and the University of Michigan. What’s more, one-fifth of nursing homes who are not ACO providers nevertheless care for a large number of residents who do participate in an ACO, they found.

A new white paper detailing the CMS Innovation Center’s proposed changes and goals can be found here.