The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation. "The center is to test innovative payment and delivery system models that show important promise for maintaining or improving the quality of care in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), while slowing the rate of growth in program costs". The center "is to give priority to twenty models specified in the law, including medical homes, all-payer payment reform, and arrangements that transition from fee-for-service reimbursement to global fees and salary-based payment". It is "intended to overcome antireform inertia by creating a mechanism for the diffusion of successful pilot programs" without requiring Congressional approval.
If a CMMI pilot model is considered successful, the Secretary of Health and Human Services may expand its duration and scope. To be considered a successful test, a model must meet three criteria:
- The Secretary determines that such expansion is expected to-- (A) reduce spending under the applicable title without reducing the quality of care; or (B) improve the quality of patient care without increasing spending;
- The Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce (or would not result in any increase in) net program spending under the applicable titles; and
- The Secretary determines that such expansion would not deny or limit the coverage or provision of benefits under the applicable title for applicable individuals.
Since its founding, CMMI has produced two models that have been certified for expansion based on meeting the above criteria: the Pioneer Accountable Care Organization (ACO) Model and the Medicare Diabetes Prevention Program.
Video Center for Medicare and Medicaid Innovation
References
Maps Center for Medicare and Medicaid Innovation
External links
- Official website
Source of article : Wikipedia
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