Citing the need for an entity that will help draw together the kinds of resources needed to spur advances in patient care quality and safety and in service to healthcare consumers, Donald M. Berwick, M.D., the administrator of the Centers for Medicare and Medicaid Services (CMS), hailed the opening of the new Center for Medicare and Medicaid Innovation (the “Center for Innovation”), in a telephone press conference held in Washington, D.C. in mid-November.
“Doctors and nurses want to provide good care for patients, they want to keep them healthy; that’s why they went into patient care in the first place,” Berwick said in an opening statement to the press. “The problem is that often, they don’t have the resources to do their best, and we have to do better. Creating a seamless care experience, producing better healthcare for patients at lower cost, through improvement” in delivery models, and innovative reimbursement experiments, will be the focus of the new Center, Berwick told members of the media.
After he made an initial statement during the press conference, Berwick was followed by healthcare leaders representing the American Medical Association, American Nurses Association, WellPoint Health Plans, a healthcare consumer advocacy group, and a representative of a statewide healthcare reform initiative in Vermont. In addition, Berwick introduced Richard Gilfillan, M.D., acting director of the Center for Innovation, who gave his own remarks.
“This is indeed an exciting time,” said Gilfillan. “We’ve been working hard to put the pieces in place to create the Center,” since the passage of the Patient Protection and Affordable Care Act (PPACA), the federal healthcare reform legislation passed by Congress and signed by President Obama in March, one of whose provisions created the Center. “Over the next 90 days, we’ll be reaching out to the community to gather stakeholder input… regarding the mission, the goals, and the operating approach we’ll take in the Center. But we’re not just in a planning process, we’re beginning to work.”
Gilfillan then announced four initial projects whose development will be guided by the Center, including:
- The creation of an eight-state, multi-payer, primary care demonstration project, which will stimulate medical home models in Maine, Vermont, Rhode Island, Pennsylvania, Michigan, Minnesota, New York, and North Carolina, and is expected to create 1,200 medical homes for 1 million Medicare beneficiaries in the next few years
- The creation of a primary care demonstration project based in community health centers; that project will test advanced primary care models in the center setting, and is expected to grow to up to 500 sites and to care for up to 196,000 patients
- The development of a Medicaid state home health option, through which states could receive 90 percent of their reimbursement for home healthcare services from the federal government, and through which Medicaid enrollees could choose to have a medical home help coordinate their care
- The testing of a variety of integrated care models for the so-called “dual-eligibles,” enrollees of both the Medicare and Medicaid programs, who tend to be older, poorer, and generally in poor health, and who historically have been challenging to care for under existing models of care
Flanking Drs. Berwick and Gilfillan at the press conference were several leaders of stakeholder groups in healthcare, including Cecil Wilson, M.D., current president of the American Medical Association, Karen Daley, R.N., Ph.D., president of the American Nurses Association, Samuel Nussbaum, M.D., executive vice president, clinical health policy, and chief medical officer at WellPoint Inc., Deborah Ness, of the national Partnership for Women and Families, and a leader in the Campaign for Better Care, and other representatives of stakeholder groups in healthcare.
Perhaps not surprisingly, the AMA’s Wilson, while applauding the creation of the Center, also called for Congress to immediately fix the “broken Medicare physician payment system,” while the ANA’s Daley called for greater recognition of advanced practice nurses and for the expansion of their roles under different potential initiatives.
In response to a question from a member of the press regarding the value of electronic medical records in facilitating some of the initiatives that will emerge from the Center, Berwick said, “Let me first say that my experience over 20 years of seeing invention occur around our nation shows that it can occur in all settings, even in the smallest practices without electronic medical records. Still, there’s no question that electronic records will be a major asset to this. I’m thrilled by the progress our country is making in modernization around electronic health records,” he added. “And the HITECH Act and progress around electronic records are well underway.”