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New Medicare/Medicaid Projects Aimed At Cheaper, Better Care

Nov 16, 2010

Promising fast action, the new Center for Medicare and Medicaid Innovation is launching a series of initiatives aimed at improving medical care while reducing its cost, officials said Tuesday.

In a conference call with reporters, Acting Innovation Center Director Richard Gilfillan and Dr. Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said the center would work quickly to assess the results of the projects and, if successful, implement them promptly.

"Time is of the essence," Berwick said. "Seven-year demonstration projects aren’t going to be responsive to the pace of change that this country now needs and that the providers of care and the patients now want …. I think we can do a lot and we can do it fast."

In one initiative, eight states will participate in a Medicare demonstration project to evaluate the effectiveness of doctors and other health professionals working "in a more integrated fashion and receiving more coordinated payment," according to CMS, the parent agency of the center and a part of the Department of Health and Human Services. The agency estimates that up to one million Medicare beneficiaries will be served by the approximately 1,200 medical homes created in the demonstration. Medical homes are teams led by physicians that focus on care coordination and can include an array of experts, such as behavioral experts and dieticians.

Another project, testing the effectiveness of doctors and other health personnel working in teams to treat low-income patients at community health centers, will coordinate care for up to 195,000 Medicare beneficiaries at 500 centers, according to CMS. In a related project, the federal government will give states money to test ways to coordinate care for Medicaid patients with at least two chronic conditions.

In a future project, the Innovation Center expects to award up to $1 million to 15 states that design programs to improve medical care for beneficiaries enrolled in both Medicare and Medicaid, who are known as "dual eligibles." The goal is to improve the quality of care and reduce its cost.

The center was created in the new health law to focus on finding ways to deliver care and pay providers to improve quality and save money for Medicare and Medicaid. Its mission includes improving care for individuals in formal settings like hospitals, nursing homes and doctors’ offices, improving care coordination and identifying and addressing major health problems, such as obesity, smoking and heart disease.

Berwick is scheduled to testify tomorrow to the Senate Finance Committee about the implementation of the health law, among other matters. It's the first time since he became head of CMS that he will face lawmakers' inquiries.


 

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