New Reports: Rapid Reform of Health Care Payment System Needed
<p>In today's new issue of <em>Health Affairs</em>, Commonwealth Fund experts offer a series of recommendations for the new Center for Medicare and Medicaid Innovation, which was established by the Affordable Care Act to develop innovative ways of providing and paying for care that have the potential to reduce costs while preserving or enhancing quality.</p>
<p>In the article <a href="/publications/journal-article/2010/jun/innovation-medicare-and-medicaid-will-be-central-health">Innovation in Medicare and Medicaid Will Be Central to Health Reform’s Success</a>, the Fund’s Stuart Guterman, Karen Davis, Kristof Stremikis, and Heather Drake stress that the new agency, which will begin full-scale operations in 2011, should be inclusive and flexible in developing and implementing payment initiatives and should continuously monitor their impact and rapidly disseminate models that appear to be successful. Among their recommendations for the center are to:</p>
<ul>
<li>Adopt a nimble "innovation with evidence development" approach in which new programs are implemented and continued as long as they show they are improving quality and value, and achieving desired outcomes; </li>
<li>Try out an array of health care payment approaches that tie payment to the delivery of high-quality, efficient, patient-centered care; </li>
<li>Include private-sector payers as well as public programs in the pilot initiatives, to achieve a broader impact. </li>
<li>Be open to payment reform approaches led by states or private entities. </li>
<li>Ensure transparency by developing explicit criteria for the selection of new programs. </li>
<li>Put continuous monitoring systems in place to identify successes and failures.</li>
</ul>
<p>"If health reform is to succeed in improving care and curbing spending, this new center must function like a research and development laboratory for health care delivery, designed to discover, support, and disseminate the best and most innovative ideas," said Karen Davis, the Fund’s president.</p>
<p>A related report from The Commonwealth Fund Commission on a High Performance Health System, <a href="/publications/issue-briefs/2010/jun/developing-innovative-payment-approaches-finding-path-high">Developing Innovative Payment Approaches: The Path to High Performance</a>, describes several payment innovations that the new center should introduce to reward more-integrated, high-value care, such as medical homes, accountable care organizations, and bundled payment.</p>
<p>Lead author Stuart Guterman, the Fund’s assistant vice president for payment system reform, said the center "offers an opportunity to be flexible in rapidly spreading promising new pilot programs" across the public and private health care sectors. "By developing this center to be quick, responsive, and engaged, we can ensure that the health care system sees the savings health care reform has the capacity to deliver."<br /></p>