The Center for Medicare and Medicaid Innovation laid out a goal to get every Medicare beneficiary and a majority of Medicaid members in an accountable care arrangement within the next 10 years, officials said during a Wednesday webinar.
The aim comes alongside a white paper released from the agency outlining its strategy for making Medicare and Medicaid more value-based within the next decade through innovative payment models, while using lessons learned from the past decade.
There are no concrete plans to stop any current models early as part of the strategy refresh, though it "will guide revisions to existing models, as well as consideration of future models," and ultimately there will be fewer models, CMMI Director Liz Fowler said on the call.
The agency also acknowledged provider concerns about current models being too burdensome and benchmarks being too complex, which CMMI aims to rectify.
"In addition to reducing overlap, we also want our models to be simpler and easier to participate in with less administrative burden," Fowler said.
"While there might be fewer models, they will move towards total cost of care approaches that will require a focus on advanced primary care and ACOs," she said.
Ultimately, the strategy moving forward will encompass "an unwavering focus on equity, to pay for health care based on value to the patient instead of volume of the services provided, and deliver affordable, person-centered care," CMS Administrator Chiquita Brooks-LaSure said during the call.
The agency wants to push innovation with five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability and partnering to achieve system transformation, according to the white paper.
The innovation center was developed in 2010 as part of the Affordable Care Act in an effort to transition the healthcare system into one that's more value-based by testing new payment and service models in Medicare, Medicaid and the Children's Health Insurance Program. Since then, the center has launched over 50 models that have generated important lessons on how to achieve that goal, according to the white paper.
In addition to driving accountable care and reducing overlap, ensuring health equity is another key pillar of the center's plan moving forward.
Officials plan to assess the individual and collective impact models have on underserved communities. They also want to increase participation among safety net providers, and "ensure that eligibility criteria and application processes don't inadvertently exclude or disincentivize care for specific populations," Ellen Lukens, director of policy and program groups at CMMI, said.
Provider groups praised the outlined goals, including the Primary Care Collaborative, which said accountable care relationships are foundational to primary care and new models could help support smaller and independent practices, according to a release.
And CMMI "properly recognizes providers' and payers' desire for greater value-based payment model consistency across all populations they serve, which is likely to lead to a more predictable and sustainable value-based ecosystem," Jeff Micklos, executive director of the Health Care Transformation Task Force, said in a release.
While the National Association of ACOs also applauded the plan, it noted CMS and the innovation center need to work to grow the Medicare Shared Savings Program, which is CMS' permanent ACO model.
"There are fewer ACOs today than any year since 2017, a trend that needs to be reversed," Clif Gaus, NAACOS president and CEO said in a release.
