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Officials Push States to Experiment with New Quality Measures, Payment Models

By Rebecca Adams, CQ HealthBeat Associate Editor

July 14, 2014 -- Federal officials recently announced that they will provide up to $100 million in funding states will be able to tap to improve the quality and efficiency of treatment in Medicaid.

States can suggest ways the money could be used to improve care, but Centers for Medicare and Medicaid Services (CMS) brass will contract with outside consultants to do much of the work involved.

States can get several types of technical assistance.

One is financial modeling to analyze ways of ways of paying doctors and hospitals that save the most money without jeopardizing the quality of care.

Officials want to test out ways to care for patients with very high medical costs and minorities whose health outcomes often are not as good as the rest of the population. CMS hopes to apply to a broader swath of the Medicaid population approaches that worked in smaller parts of that population or for people who have other types of coverage. States also could work with CMS and outside consultants to examine data from Medicare and Medicaid to find more efficient ways of delivering care.

Another focus is to improve quality of care measures and find ways to more effectively disseminate information to states about what works best. Funding also could pay for faster federal evaluations of existing state efforts such as their increased use of managed care.

CMS said it wants to coordinate communication so state officials don't have to make repeated calls to the agency about the same issue.

The new project stems in part from recommendations by National Governors Association (NGA) in February. Health and Human Services (HHS) Secretary Sylvia Mathews Burwell met July 13 with governors at their summer meeting in Nashville.

The co-chairs of an NGA task force on health care—Tennessee GOP Gov. Bill Haslam and Oregon Democratic Gov. John Kitzhaber—praised the HHS announcement.

"We are very pleased by this new effort to develop performance partnerships with states that can deliver better health outcomes at a cost we can afford," said Kitzhaber.

"I appreciate the continued conversations CMS has had with us about these areas," said Haslam.

CMS officials are taking suggestions about how to identify a small group of states that would be interested in experimenting with new technical tools or ways of offering care. Those states' experiences would be shared with other states, according to a "frequently asked questions" document posted online.

Known as the Innovation Accelerator Program, the new effort is similar to the CMS State Innovation Models project. But the latter uses cooperative agreements with states to fund projects while the new initiative emphasizes federally-funded technical assistance. The innovation project involves broader initiatives that can include other issues or more than one payer, while the new project is focused on Medicaid.

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