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Newsletter Article


Innovation Center Opens for Business

By Rebecca Adams, CQ HealthBeat Associate Editor

November 16, 2010 -- Federal officials Tuesday launched a new center that will spend $10 billion over the next decade to test different Medicare payment and health care delivery ideas that Obama administration officials hope will change health care throughout the nation. The division is called the Center for Medicare and Medicaid Innovation.

Centers for Medicare and Medicaid Services (CMS) Administrator Donald M. Berwick, who has said that he spends the majority of his time thinking about the ideas that he hopes the center will incubate, announced four big projects that the center will fund.

Among the outside groups cheering the move were insurance company executives, who have not always supported all the aspects of the health care law (PL 111-148, PL 111-152).

"Within the private sector, innovative designs are flourishing, and part of the work of the new center will involve partnerships with these initiatives and the dissemination of information about what is working so that successful designs can be replicated across the country," Karen Ignagni, president and chief executive of the trade group America's Health Insurance Plans, said in a statement. "Our plans look forward to working with CMS as the new center progresses."

Berwick said that if doctors and nurses better coordinate patients' treatments, big safety problems such those detailed in a recent report can be avoided. The report—by the Health and Human Services Department's inspector general—found that one in seven Medicare seniors who is hospitalized suffers from a medical error or other problem while in the hospital. In October 2008, about 134,000 Medicare patients were harmed by at least one action while hospitalized, and 44 percent of them were preventable mistakes.

Berwick said he has carefully read the report. One of the big problems, he said, is that when different providers step in and take over a patient's care, they may not be fully informed about someone's prior treatment. Lab test results can get lost. Medications can be given more than once and other problems can pop up when patients are cared for by different providers.

The center's work on integrating care can help, Berwick said, because it will encourage a "connection between safety and coordinated care."

Up to one million seniors in eight states could participate in a demonstration project that will test out the impact of requiring doctors to coordinate Medicare beneficiaries' care. The doctors and other medical professionals will get payments from Medicare, Medicaid and private insurers.

About 195,000 seniors will be able to get their care in a similarly coordinated program through federal health clinics.

The Center for Medicare and Medicaid Innovation will also provide million-dollar grants to help states create other new programs for integrated care.

And state Medicaid officials will be able to give coordinated care to patients who have at least two chronic conditions. States that implement this option can get a higher matching payment from the federal government.

The new center is headed by Richard Gilfillan, a family doctor who from 2005 to 2009 served as president and CEO of Geisinger Health Plan and executive vice president of system insurance operations for the Geisinger Health System in Danville, Pa., which is nationally known for integrating medical services.

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