The Center for Medicare and Medicaid Innovation created by the Patient Protection and Affordable Care Act has launched a website and issued a fact sheet describing its first activities. The Center will pursue three goals: 1) Better Care for Individuals (making care safer, more patient-centered, more efficient, more effective, more timely and more equitable in hospitals, nursing homes and doctor’s offices and promoting bundled payments); 2) Coordinating Care to Improve Health Outcomes for Patients (using advanced primary care and health home models and supporting innovations in accountable care organizations) and 3) Community Care Models (exploring steps to improve public health and make communities healthier and stronger, especially addressing issues such as obesity, smoking and heart disease).
And the Center announced its first initiatives:
1) A Multi-Payer Advanced Primary Care Practice Demonstration Project, with eight states (Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota) establishing up to 1,200 medical homes with payments from Medicare, Medicaid and private health plans, serving almost one million Medicare beneficiaries
2) A Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration with up to 500 community health centers providing patient-centered, coordinated care to 195,000 Medicare beneficiaries.
3) Launch of a Medicaid Health Home State Plan Option which allows Medicaid patients with at least two chronic conditions to designate a provider as a health home; states that implement this option will receive enhanced federal matching funds for their Medicaid program to support these health homes.
4) Availability of a demonstration project for up to 15 states to integrate and coordinate care for Medicare and Medicaid dual eligibles (low income seniors and persons with disabilities); up to $1 million is available to each of the 15 states.
While many of these initiatives were mandated by the PPACA, it is interesting that the Center seems to be using the terms “health homes”, “advanced primary care practice” and “medical homes” interchangeably and also seems to focused primarily on Medicare beneficiaries (for example, even in the FQHC demonstration, when most FQHCs see far more patients on Medicaid than Medicare). It will also be interesting to see how the Center implements activities under its third goal since population level community health has not been a strong focus of Centers for Medicare and Medicaid Services initiatives and have been led by other operating divisions of the U.S. Department of Health and Human Services, namely, the Centers for Disease Control and Prevention.
Ignatius Bau 