About The CMS Innovation Center
The Center for Medicare and Medicaid Innovation (the “CMS Innovation Center") presents the Centers for Medicare and Medicaid Services (CMS) and the country with an opportunity to improve our healthcare system for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries — and in doing so improve the healthcare system for the entire nation.
The Innovation Center has the ability to test, evaluate and spread the best solutions from the diversity of innovators around the country in which:
- Patients receive the right care, at the right time, in the right setting — every time
- The delivery system is constantly improving — continuous innovation leads to higher quality and lower costs
- Care is coordinated, so that the transitions and communication between healthcare providers and patients are seamless
- Providers are supported in providing safe, coordinate, seamless care
- Prevention and keeping patients healthy are given as much priority as treating illness
- Healthcare resources are used efficiently and effectively
- The best clinical and delivery system practices spread rapidly
- A full range of tools — payment, communication, health information technology, training, quality measurement, regulation and more — are brought together so the system works better for beneficiaries, families, clinicians and other healthcare providers
Congress created the Innovation Center under the Affordable Care Act, giving the Center the authority and direction to “test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care” for those who get Medicare, Medicaid or CHIP benefits.
The Innovation Center “evaluate[s] each model on the quality of care furnished and the changes in spending.” The Center’s mandate gives it great flexibility in selecting and testing innovative payment and service delivery models, enables the Center to work with Medicare, State Medicaid and CHIP programs to better serve beneficiaries, and provides $10 billion in direct funding in fiscal years 2011 through 2019 to support this mission. It also allows the Secretary of Health and Human Services to expand, through rulemaking, the scope and duration of models proven effective after evaluation, including implementation on a nationwide basis to cover the entire Medicare, Medicaid, or CHIP populations. In order to expand a model, the Secretary must determine that the model improves the quality of patient care, and the CMS Actuary must certify that expanding the program will lower costs (or at least not increase costs).
The Innovation Center is part of a broader effort by CMS and other federal agencies to support and help clinicians and other health care providers deliver higher quality care. With the help of the Innovation Center, CMS is working to transform from a claims payer in a fragmented care system into a partner that helps achieve better value for our health care dollars. It is working to create a health care system that provides seamless, coordinated care for beneficiaries.
Read Section 3021 of the Affordable Care Actwhich established the Innovation Center.