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CMS Makes $840 Million Bet on Changing Medicare at Practitioner Level

By Kerry Young, CQ HealthBeat Associate Editor

October 23, 2014 – Last week a federal health agency unveiled how it intends to spend a major slice of a $10 billion account established to try ideas for improving the practice of medicine.

The latest plan from the Center for Medicare and Medicaid Innovation is the $840 million Transforming Clinical Practice Initiative. While other programs within the center focus on changing practices within hospital and physician practices, the new initiative is designed to more intensely involve nurses, physicians' assistants and pharmacists, as well as primary-care doctors, the agency said in a fact sheet.

"We look forward to a large number of applications," said Patrick Conway, the Centers for Medicare and Medicaid Services (CMS) deputy administrator for innovation and quality and chief medical officer, on a call with reporters.

The 2010 health law (PL 111-148, PL 111-152) provided $10 billion for the innovation center at CMS, meant as an engine to move federal health programs away from the fee-for-service model and toward more integrated forms of health care.

The challenge for the innovation center is to test out ideas for improving medical practice. This money runs out in fiscal 2019. In the current budget environment, gaining another large infusion of funds for such testing of ideas may prove difficult.

For the newly announced initiative, the bulk of the money comes from funds provided through the 2010 health law for the Center for Medicare and Medicaid Innovation, with the remaining $40 million taken from money approved for the Quality Improvement Organization program.

CMS expects to make awards of $2 million to $50 million each for participants in the four-year practice transformation network program, which is part of this new initiative. Organizations expected to participate in this program include health and hospital systems and large-group practices.

The goal is to foster cooperative sharing and mentoring within the medical community on best practices, said Health and Human Services Secretary Sylvia Mathews Burwell in a statement.

"We want everyone who is willing—large, medium, and small practices—to be able to practice medicine with a focus on quality," she said. "We're not seeking to impose reforms from the top down. We want to help you innovate. And we can draw inspiration from physicians, providers, and medical professionals all over the country who are doing just that."

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