Health System Reform Insight - Dec. 2, 2011
Given the new direction for the nation’s health system, the AMA has developed Health System Reform Insight to help you understand what this new direction means to you and your patients.
The Center for Medicare and Medicaid Innovation (CMMI) has announced a new direct funding opportunity for a wide range of local proposals that implement new payment and delivery models to improve medical care outcomes for Medicare, Medicaid and Children's Health Insurance Program beneficiaries.
Known as the Health Care Innovation Challenge, CMMI will provide direct funding in amounts of $1 million to 30 million per project, which will be paid over a three-year period. Federal funds totaling $1 billion are available to support these projects.
CMMI is inviting interested parties who have developed innovations that will drive significant health care improvements to apply. A wide range of organizations may apply, including physician and other provider groups, health systems, payers, other public-private partnerships and for-profit organizations. In addition, certain organizations could be eligible to apply as conveners, which would assemble and coordinate the efforts of a group of participants.
Objectives for proposals
Proposals should be designed to address the following three CMMI objectives:
- Engage a broad set of innovation partners at the local level to identify and test new delivery and payment models that produce better care, improved health and reduced costs. These results should be reached through improvement efforts and impact identified target populations.
- Identify new models of workforce development and deployment as well as training and education that support these models. For example, a physician practice may propose to hire a nurse care manager to assist in care coordination activities.
- Support innovators who can deploy care improvement models through new ventures or expansion of existing efforts to new populations of patients within six months of the award. When possible, these ventures should be undertaken in conjunction with other public and private sector partners.
Sustainability of models
CMMI has made clear that the Health Care Innovation Challenge is not a shared savings approach. Rather, the three-year grants are direct funding awards made through cooperative agreements.
As part of the application, those who apply must present a plan for long-term sustainability of the project once the CMMI grant expires. An example of long-term sustainability would be the establishment of a partnership with other key stakeholders, such as a private payer or local employer.
Application process and deadlines
There are two cycles for applications and awards. Applicants for the first round must submit a letter of intent by Dec. 19 and file the full electronic application by Jan. 27. Visit the Health Care Innovation Challenge Web page and follow the instructions in the "application information" section to submit your application. Awards will be made March 30.
Application deadlines have not yet been announced for the second round. These awards will be made in August 2012.
Physicians who wish to change their Medicare participation status must do so by the end of the year. The AMA's newly updated Medicare Participation Kit helps physicians assess which Medicare participation option might be best for their practices.
Medicare physician payments are scheduled to be cut by 27 percent. Ask your members of Congress what specific steps they will take to end annual Medicare physician payment cuts: Send an urgent email or call the AMA grassroots hotline at (800) 833–6354.