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State Innovation Models             Centers for Medicare and             Medicaid Services             July 26, 2012      ...
AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA V...
Our health care system is in transitionCurrent System                       Future System •   Provides the best acute care...
CMMI tests, evaluates and scales innovative payment            and service delivery models  “The purpose of the Center is ...
We measure our success in terms of better health,      better health care and lower cost1. Better health:        Better he...
AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA V...
Overview: The State Innovation Models Initiative to   design, test, and replicate successful models                       ...
State Health Care Innovation Plan• State’s comprehensive approach to transform its health care system• Submitted by Govern...
States may apply for one of two types of awardsAward Type   Description                                                   ...
CMS will partner with states to drive health system                 transformation   • Provide technical assistance to sta...
AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA V...
States can use many levers to drive changeApproach          Description                                    Example/Effect ...
A reformed health system will reward those who care        for the health of entire populations                           ...
AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA V...
What do states need to do to participate?Engage              stakeholdersPlan and design     a comprehensive approach for ...
EligibilityOnly Governor’s Offices or the Mayor of Washington, DC can applyOne application per state for Model Design or M...
AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA V...
Award TimelineModel Design:                   Applications                        Period of                       due:    ...
Next Steps• Additional webinars will be scheduled for state policy makers –  these will focus on Model Design and Model Te...
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Webinar: State Innovation Models Initiative - Overview

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In this July 26, 2012 webinar, CMS Innovation Center staff provided an overview of the State Innovation Models Initiative.
More information can be found at: http://innovations.cms.gov/initiatives/state-innovations/index.html.

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CMS Innovation Center
http://innovation.cms.gov

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Transcript of "Webinar: State Innovation Models Initiative - Overview"

  1. 1. State Innovation Models Centers for Medicare and Medicaid Services July 26, 2012 Webinar
  2. 2. AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA Vision for the Future: State Health Care Innovation PlansHow to ParticipateAward Timeline and Next Steps 2
  3. 3. Our health care system is in transitionCurrent System Future System • Provides the best acute care • Affordable in the world • Accessible - to care and to information But, our system is: • Seamless and Coordinated • Uncoordinated – • High Quality - timely, equitable, Fragmented delivery safe systems with highly variable • Person and Family-Centered quality • Supportive of Clinicians in serving • Unsupportive of patients their patients needs and physicians • Unsustainable – Costs rising at twice the inflation rate 3
  4. 4. CMMI tests, evaluates and scales innovative payment and service delivery models “The purpose of the Center is to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and CHIP…while preserving or enhancing the quality of care furnished.” • Resources: $10 billion funding for FY2011 through 2019 • Opportunity to scale: The HHS Secretary has the authority to expand successful models to the national level 4
  5. 5. We measure our success in terms of better health, better health care and lower cost1. Better health: Better health as measured by individual and population metrics2. Better health care: Improved experience of care measured by safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity metrics3. Lower costs: Lower total cost of care through improvement 5
  6. 6. AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA Vision for the Future: State Health Care Innovation PlansHow to ParticipateAward Timeline and Next Steps 6
  7. 7. Overview: The State Innovation Models Initiative to design, test, and replicate successful models Goals• Partner with states to develop and implement broad-based State Health Care Innovation Plans• Plan, design, test, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation• Utilize the tools and policy levers available to states• Engage a broad group of stakeholders in health system transformation• Coordinate multiple strategies into a plan for health system improvement 7
  8. 8. State Health Care Innovation Plan• State’s comprehensive approach to transform its health care system• Submitted by Governor and State officials in consultation with stakeholders• Describes strategy for delivery system evolution into a higher quality, higher value health care delivery system• Includes multi-payer payment and service delivery models the State plans to test• Coordinate state health care and health programs & functions, such as: licensing, accreditation, health departments, insurance oversight, educational assistance, publically supported provider entities, etc. 8
  9. 9. States may apply for one of two types of awardsAward Type Description Funding Amount ● Provide financial and technical support to states to for their ● $1-3 million per state planning and design efforts ● Support for up to ● Plans will be comprehensive and include multi-payer payment 25 statesModel and delivery system modelsdesign ● Models should strive to move states toward community-led integrated care strategy and promote improvements in cost, quality and population health ● Provide financial and technical assistance to states that are ● $20-60 million per state, ready to implement a State Health Care Innovation Plan, over 3+ years including testing and evaluating multi-payer, outcomes-based ● Support for up to payment and delivery models 5 statesModel ● Move the preponderance of care in the state from models thattesting reward service volume to clinical and financial models that reward better health, better care, and lower cost through improvement ● Second round of funding anticipated in spring of 2013 9
  10. 10. CMS will partner with states to drive health system transformation • Provide technical assistance to states States’ Role • Provide Medicare data to states Innovation Center Role • •Convene broad tools and stakeholders to Offer project group of business systems •design transformative models system and Evaluate impact of • Provide technical assistance to states delivery multi-payer payment models • Provide Medicare data to states (as applicable) • Implement and test the models for cost, • Evaluate impact of models quality, population health improvements Together …we will work to create a more coordinated health system that improves overall population health 10
  11. 11. AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA Vision for the Future: State Health Care Innovation PlansHow to ParticipateAward Timeline and Next Steps 11
  12. 12. States can use many levers to drive changeApproach Description Example/Effect ▪ Change payment models that impact ▪ Develop and scale ACOs, bundledNew payment the way Medicaid, Medicare and other payment programs, patient-centeredmodels private health insurance programs pay medical homes for care ▪ Use state leadership to bring all payers ▪ Increase impact of public payment reformConvenepayers to the table ▪ Move preponderance of care to value- based models ▪ Develop innovative policies around ▪ Enhance primary care capacity, integrateShape health licensure and training of health care community health care needs withcare workforce workers and programs graduate medical education other health professionalsOrganize ▪ Coordinate public health system with ▪ Address the underlying determinants ofpublic health delivery system healthservicesIntegrate ▪ Create value-based clinical and ▪ ACOs or patient-centered medical homesbehavioral business modelhealth services 12
  13. 13. A reformed health system will reward those who care for the health of entire populations Coordinated Community Acute Health Care Seamless Health Integrated Health System Care System Care System High quality acute care • High quality acute care • High quality acute care • Accountable care systems Accountable care systems • Accountable care systems • Shared financial risk Shared financial risk • Shared financial risk • Case management and Case management and • Case management and preventive care systems preventive care systems preventive care systems • Population-based quality Population-based quality • Population-based quality and cost performance and cost performance and cost performance • Population-based health • Population-based health Population-based health outcomes outcomes outcomes • Care system integration • Care system integration Care system integration with community health with community health with community health resources resources resources 13
  14. 14. AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA Vision for the Future: State Health Care Innovation PlansHow to ParticipateAward Timeline and Next Steps 14
  15. 15. What do states need to do to participate?Engage stakeholdersPlan and design a comprehensive approach for transforming the state health systemCreate payment and service delivery modelsIntegrate clinical and behavioral care, prevention and community healthy living supports into a coordinated care modelUse policy levers available to the stateIntegrate with HHS and other Affordable Care Act initiativesDemonstrate the model is successful and sustainable 15
  16. 16. EligibilityOnly Governor’s Offices or the Mayor of Washington, DC can applyOne application per state for Model Design or Model TestingAll states, the District of Columbia and U.S. Territories may submit applicationsGovernors may designate a governmental entity to receive fundsNon-profit or other organizations are not eligible to apply 16
  17. 17. AgendaBackground: The Center for Medicare and Medicaid InnovationIntroduction to the State Innovation Models InitiativeA Vision for the Future: State Health Care Innovation PlansHow to ParticipateAward Timeline and Next Steps 17
  18. 18. Award TimelineModel Design: Applications Period of due: Anticipated performance:Announcement : September 17, award date: From award date July 19, 2012 2012, November 2012 through 5 p.m. EDT May 14, 2013Model Testing (Round One): Period of performance: Up to Applications 12 months for due: AnticipatedAnnouncement : waiver review/pre- September 17, award date: July 19, 2012 implementation 2012, by November 2012 and 36 months for 5 p.m. EDT implementation and testing 18
  19. 19. Next Steps• Additional webinars will be scheduled for state policy makers – these will focus on Model Design and Model Testing• Submit questions to StateInnovations@cms.hhs.gov• FAQs will be updated and posted to the Innovation Center website at innovation.cms.gov• Additional information is available on our website: innovation.cms.gov/initiatives/state-innovations 19
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