CMS: Centers for Medicare & Medicare Services, Navigating Innovative Models in 2017
Now that Rep. Tom Price has been confirmed for Health and Human Services (HHS) Secretary, he can halt some of the agency’s mandatory programs, such as the Comprehensive Joint Replacement (CJR) model. However, value-based models will likely remain part of the national strategy moving forward since they are promoted by payers, private insurers, and Medicare.
As the industry spins through a cycle of payment experimentation, providers assume more risk for outcomes and collaboration between health plans, physicians, and hospitals becomes increasingly important.
If, as suspected, states are granted more flexibility to operate their Medicaid programs, methodologies that emphasize population health are likely safest. Under the seven Center for Medicare and Medicaid Innovation (CMMI) categories, healthcare organizations can find attractive options around areas that best exemplify their care models.