Health Care Innovation Awards

The first batch of Health Care Innovation Awards include several projects that aim to deliver better health, better care and lower costs through improvement to people enrolled in Medicaid programs.  Some of these projects propose to test ideas that are new to Medicaid—others propose new ways to synergize with existing state Medicaid efforts already underway.  The full list of Innovation Awards projects can be found at www.innovations.cms.gov/initiatives/Innovation-Awards/Project-Profiles.html, or you can download a list of Medicaid-related projects.

The CMS Innovation Center has a number of initiatives and demonstrations underway that encourage better care and better health, innovative projects that test  new payment and service delivery models to deliver high-quality health care services and lower costs. See these examples below:

COMPREHENSIVE PRIMARY CARE INITIATIVE

The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Medicare will work with commercial and State health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients.  In some instances, the CMS Innovation Center is also providing Medicaid fee-for-service care management fees to practices.  More information about this initiative can be found at http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/index.html.

MEDICAID EMERGENCY PSYCHIATRIC DEMONSTRATION

This Demonstration will test whether Medicaid can support higher quality care at a lower total cost by reimbursing private psychiatric hospitals for certain psychiatric services for which Medicaid reimbursement has historically been unavailable.

CMS worked collaboratively with private non-profit organizations and across the Department of Health and Human Services (HHS) to develop this demonstration. Partners included the National Association of Psychiatric Health Systems (NAPHS), and, within HHS, the Office of the Assistant Secretary for Planning & Evaluation (ASPE) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

More information on this project can be found at http://innovation.cms.gov/initiatives/Medicaid-Emergency-Psychiatric-Demo/index.html.

MEDICAID INCENTIVES PROGRAM FOR THE PREVENTION OF CHRONIC DISEASES

Interventions that address the behavioral or social circumstances that influence participation in preventive health services and/or otherwise have a positive impact on outcomes of preventive health services may contribute to improving health and decreasing growth in health care expenditures.

Section 4108 of the Affordable Care Act authorizes grants to States to provide incentives to Medicaid beneficiaries of all ages who participate in prevention programs and demonstrate changes in health risk and outcomes, including the adoption of healthy behaviors.  Additional information about this program can be found at http://innovation.cms.gov/initiatives/MIPCD/index.html.

STATE INNOVATION MODELS

The State Innovation Models initiative is a $275 million competitive funding opportunity for States to design and test multi-payer payment and delivery models that deliver high-quality health care and improve health system performance.

States are an important partner in health care, providing services through Medicaid, the Children’s Health Insurance Program (CHIP) and their public health departments. States are in a unique position to develop and test innovative models that can help support efforts that can deliver better health, better care and lower costs. 

Additional information about the State Innovations Models can be found at http://innovation.cms.gov/initiatives/state-innovations/index.html.

STRONG START FOR MOTHERS AND NEWBORNS

The Strong Start initiative supports reducing the risk of significant complications and long-term health problems for both expectant mothers and newborns.

Babies born prematurely are a growing public health problem with significant consequences for families and an estimated cost to society of at least $26 billion each year. Each year, this is more than half a million infants in the United States, a number that has grown by 36 percent over the last 20 years.

Infants born preterm are at greater risk for mortality and many endure a lifetime of developmental and health problems. In addition to enormous medical needs, these children often require early intervention services, special education and have conditions that impact their productivity as adults. 

This initiative builds on decades of work by organizations like ACOG, the March of Dimes, the National Partnership for Women and Families, the Society for Maternal-Fetal Medicine, and Childbirth Connection, showing that elective deliveries before 39 weeks increase the risk of significant complications for both the mother and the baby, as well as long-term health problems. In addition, Strong Start’s goals and focus were identified with the help of experts at the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), ACF and HRSA.

Strong Start includes two strategies:

• Public-Private Partnership to Reduce Early Elective Deliveries. Building on the work of the Partnership for Patients, this initiative will test ways to encourage best practices and supports providers in reducing early electives deliveries prior to 39 weeks. CMS will also team up with advocacy and professional organizations to increase current public awareness efforts and develop new ones. See what you can do to help reduce early elective deliveries.
• Funding Opportunity for Testing New Approaches to Prenatal Care. CMS is making funding available for providers, states and other eligible applicants to test the effectiveness of three enhanced prenatal care approaches to reduce preterm births for women covered by Medicaid who are at risk for preterm births.

More information on the Strong Start initiative can be found at http://innovation.cms.gov/initiatives/Strong-Start/index.html.