CMS is listening. Are you part of the conversation?

Friday, February 24, 2012

My main takeaway from the CMS's Health Care Innovations Summit on Jan. 26 is that CMS is definitely trying to dispel any notion that it might be a slow moving, bureaucratic agency. The Center for Medicare & Medicaid Innovation (CMI) has $10 billion to invest in innovative ideas. The health reform law requires CMI to test payment and service delivery models to determine their effectiveness at controlling expenditures while delivering quality care to beneficiaries within the Medicare, Medicaid or the State Children's Health Insurance Program (CHIP). Moving beyond the traditional demonstration projects CMS has conducted for 40 years, the agency now has the authority to implement CMI projects of unlimited duration on a national basis if they reduce government spending and improve the quality of care. Marilyn Tavenner, the new acting administrator of CMS, and Dr. Rick Gilfillan, the head of CMI, made it clear that every project at CMI would be measured against CMS's three-part aim: better care and better health at lower costs through continuous improvement.

CMS infused energy and enthusiasm typically not associated with federal agencies into the Summit. The excitement of federal speakers gave the Summit the feel of a SalesForce or Facebook technology industry event. The attitude framed CMS as more innovative and accessible. This is impressive for an agency that spends $760 million annually for care for seniors, people with disabilities and people of limited means, and that is responsible for $0.35 of every healthcare dollar spent in the United States before it implements the health insurance exchanges required by the health reform law.

In addition to speeches by Tavenner and Dr. Gilfillan, key government officials and opinion leaders delivered remarks, including Jonathan Blum, director for the Center for Medicare; Aneesh Chopra, U.S. Chief Technology Officer; Todd Park, Chief Technology Officer for the U.S. Department of Health and Human Services; and Atul Gawande, MD, MPH, surgeon, writer and public health researcher.

CMS's new approach is refreshing and CMI should host more events focusing on health innovation, but there is room for improvement. For example, CMI billed the Summit as an opportunity for knowledge sharing between innovators with the intent to drive transformation of the healthcare system. While the speeches were great, almost 1,000 innovators spent most of the day in their seats listening to speeches without an opportunity to offer comments or ask questions. The lack of an attendee list hampered the ability of innovators to network with potential partners. CMS should provide brief descriptions and contact information from the thousands of organizations that submitted applications to present at the Summit that were not selected for an "ignite talk." Such a publication will allow attendees and others to network and share ideas, capitalizing on the Summit's momentum.  

The Summit did not highlight any home medical equipment (HME) providers. One home medical technology was part of a featured innovation program, CareMore. That program reduced hospital admissions by 50% using wireless scales to remotely monitor weight in patients with congestive heart failure. Nevertheless, there is an opportunity for HME providers to get in the game by collaborating with health insurers, health systems, long-term care facilities, home health agencies and other entities that currently provide CMS covered services. For example, HME manufacturers and suppliers could work with health insurers to show how payment systems for HME other than a fee schedule or competitive bidding could improve the quality  of care provided to Medicare, Medicaid or CHIP beneficiaries while reducing program costs. Like other innovators, it is imperative that HME innovators take a proactive approach, develop entrepreneurial ideas and bring those ideas to CMI's attention rather than waiting for CMI to announce a specific opportunity. 

Overall, the CMI Summit was a great start and I hope CMS will build on this experience and sponsor other types of events that engage the private sector. As Todd Park said at the Summit, "There is no problem America can't invent its way out of." The United States will have to invent a politically palatable, economically sound alternative to fee-for-service to enable the delivery of quality care while managing costs. HME providers can and should be part of that solution. The majority of the $10 billion remains available for new ideas that improve the quality of care while reducing federal healthcare costs. Innovative HME providers should seize the opportunity to pitch their ideas to CMI and demonstrate how the industry can contribute to healthcareinnovation. hme

Jim Scott is the president and CEO of Applied Policy, a health policy and reimbursement consulting firm. Reach him at 202-558-5272, or