CMS Center for Medicare and Medicaid Innovation

April 7, 2011

As part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) created the Center for Medicare and Medicaid Innovation (CMI). The CMI is charged with testing innovative payment and service delivery models with the goal of reducing program costs while maintaining or improving the quality of care for Medicare, Medicaid and CHIP beneficiaries. As clinicians, health systems and community leaders develop new models to bring about better health, better health care and lower costs, the CMI wants to partner with these groups to identify models for change and rapidly expand their adoption throughout the Medicare, Medicaid, and CHIP programs.

Currently the CMI is actively seeking suggestions for innovative models that it can evaluate based on potential improvements in quality of care and reductions in spending. The Center’s mandate allows it to select and test innovative payment and service models and provides $10 billion in funding to help pay for pilot programs that will work within Medicare, state Medicaid, and CHIP programs.

The CMI solicits ideas for new models via a web-based submission form. The most promising model proposals are evaluated against CMI criteria, and then are tested and evaluated by working with partnering organizations to see if they can achieve the three critical aims of better healthcare, better health and reduced cost. Clear, objective benchmarks are established and evaluation is terminated if they are not met. Successful models that meet cost and quality tests may be expanded to the entire Medicare, Medicaid, or CHIP programs.

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