Before the enactment of the Patient Protection and Affordable Care Act (ACA) in 2010, experimentation with Medicare or Medicaid programs was prolonged, onerous, and often indecisive.1 The requisite congressional approval for each new model test constituted a lengthy and bureaucratic process, the implementation and evaluation of approved model tests lingered for years, and derived results were often out of date by the time they were finally available.1 It is against this backdrop that section 3021 of the ACA established the Center for Medicare and Medicaid Innovation (CMMI), replete with $10 billion in guaranteed federal appropriation for 2010 through 2019.2 Ensconced within the Centers for Medicare & Medicaid Services (CMS), the CMMI was to expand the scope and accelerate the pace of learning with an eye toward hastening the transition from fee-for-service payment models to value-based care. Now in its second decade, the CMMI resolved to review its past and plan its future in a recently unveiled report titled “Innovation Center Strategy Refresh.”3 The objective of this Viewpoint is to review this long-anticipated strategic plan of the CMMI and to explore the key takeaways thereof.
If only 6 of 50 tested models brought better value care, that's 12.6% and not ready for broad implementation.
Medicare and Medicaid are good at low overhead bill-paying but we should leave innovation to the people who do it best, probably Silicon Valley. Not Washington, DC.
McDonough JE, Adashi EY. The Center for Medicare and Medicaid Innovation—Toward Value-Based Care. JAMA. 2022;327(20):1957–1958. doi:10.1001/jama.2022.6927
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