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CMS—Engaging Multiple Payers in Payment Reform

CMS—Engaging Multiple Payers in Payment Reform Opinion CMS—Engaging Multiple Payers VIEWPOINT in Payment Reform The Affordable Care Act created the Center for Medi- CMS has a long history of both testing and imple- Rahul Rajkumar, MD, JD care and Medicaid Innovation (Innovation Center) to test menting innovative new payment and delivery models Centers for Medicare & innovative payment and service delivery models to re- for Medicare and Medicaid. But historically, CMS has not Medicaid Services, duce program expenditures under Medicare, Medicaid, actively sought the participation of other payers in new Washington, DC, and and the Children’s Health Insurance Program (CHIP) and payment models. If new payment models deployed by Brigham and Women’s Hospital, Boston, to enhance the quality of care that Centers for Medicare CMS have improved quality and reduced cost, other pay- Massachusetts. & Medicaid Services (CMS) beneficiaries receive. CMS is ers have followed—but CMS has not typically actively en- testingmorethan20modelsunderthisauthoritythatcre- gaged private payers. Patrick H. Conway, atenewincentivesforcliniciansandorganizationsthatde- One widely studied example of this approach is MD, MSc liver medical care through CMS programs to deliver bet- Medicare’s implementation of the inpatient prospec- Centers for Medicare & Medicaid Services, ter care at lower cost. CMS is also supporting a variety of tive payment system http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

CMS—Engaging Multiple Payers in Payment Reform

JAMA , Volume 311 (19) – May 21, 2014

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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2014.3703
pmid
24752342
Publisher site
See Article on Publisher Site

Abstract

Opinion CMS—Engaging Multiple Payers VIEWPOINT in Payment Reform The Affordable Care Act created the Center for Medi- CMS has a long history of both testing and imple- Rahul Rajkumar, MD, JD care and Medicaid Innovation (Innovation Center) to test menting innovative new payment and delivery models Centers for Medicare & innovative payment and service delivery models to re- for Medicare and Medicaid. But historically, CMS has not Medicaid Services, duce program expenditures under Medicare, Medicaid, actively sought the participation of other payers in new Washington, DC, and and the Children’s Health Insurance Program (CHIP) and payment models. If new payment models deployed by Brigham and Women’s Hospital, Boston, to enhance the quality of care that Centers for Medicare CMS have improved quality and reduced cost, other pay- Massachusetts. & Medicaid Services (CMS) beneficiaries receive. CMS is ers have followed—but CMS has not typically actively en- testingmorethan20modelsunderthisauthoritythatcre- gaged private payers. Patrick H. Conway, atenewincentivesforcliniciansandorganizationsthatde- One widely studied example of this approach is MD, MSc liver medical care through CMS programs to deliver bet- Medicare’s implementation of the inpatient prospec- Centers for Medicare & Medicaid Services, ter care at lower cost. CMS is also supporting a variety of tive payment system

Journal

JAMAAmerican Medical Association

Published: May 21, 2014

References