New Medicaid program seeks to foster innovation
Tuesday, August 05, 2014
On July 14, the Centers for Medicare & Medicaid Services announced the Medicaid Innovation Accelerator Program (IAP), a group of technical assistance tools.
The aim of this program is to improve the health of Medicaid beneficiaries, thereby supporting the Triple Aim, and reducing overall costs for the Medicaid program.
The program includes initiatives in four key areas:
1. Identification and advancement of new models
This focuses on areas of high cost, disease burden or disparities among Medicaid recipients. The focus will involve work in the areas of integrated care and policy (i.e., medical/health homes, accountable care organizations, care models that are person-centered, continuous, coordinated and comprehensive), along with shared savings methodologies. One area of importance already identified by Medicaid is substance use disorders.
2. Promote advances in data analytics and financial modeling
The goal is to improve treatment interventions, clarify best practices and maximize capacity. This area will rely heavily on a large-scale database: the Medicaid Statistical Information System (MSIS), which contains key statistics on eligibility, enrollment, program, utilization and expenditure data for the Medicaid and Children's Health Insurance Program (CHIP).
3. Advance quality measurement and initiatives across all programs
This will include more frequent utilization of the child, adult and health home core-data sets. The child and adult core sets (released December 2013 and January 2014, respectively) includes quality measures in the areas of physical and mental health, including chronic conditions.
The health home core set reflects key priority areas such as behavioral health and preventive care, and aligns with the adult core set of healthcare quality measures. Quality measurement initiatives will include a minimum of six components: goals, interventions, metrics, targets, transparency and feedback.
4. Improved communication between states on cross-cutting issues, rapid cycle improvement and best practices
Work in this area will capitalize on current projects that include the Medicaid and CHIP Learning Collaborative (workgroups of state and federal officials designed to reinforce a stable health insurance infrastructure) and associated toolbox generated by the workgroup (i.e., technical assistance tools, state resources, pertinent background materials).
Additional projects include the Maternal and Child Health Initiative (focus is to the enhance the volume and structure of postpartum visits and to boost utilization of contraception among members) and Prevention Learning Network (a technical resource to states on preventive health care services like immunizations, screenings, and clinical and behavioral interventions for chronic disease).
Medicaid IAP is different from the State Innovation Models (SIM) program, which provides funding for state-driven healthcare innovation in broad areas like population health and delivery of care. Medicaid IAP is limited to technical assistance and does not provide a funding mechanism for projects.
It is estimated that the U.S. Department of Health and Human Services will invest more than $100 million in this reform program. This initiative represents one of numerous attempts to foster innovation in a program that is often criticized for its out-of-date or ineffective policy.
The agency solicits feedback and suggestions from states and other stakeholders via a dedicated CMS mailbox: MedicaidIAP@cms.hhs.gov.
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