Catalyzing Innovative Health System Transformation : An Opportunity Agenda for the Center for Medicare & Medicaid Innovation

Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume. This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI's Strategic Refresh. Table of ContentsFront Matter1 Introduction and Initiative Background2 Expert Panel Review Highlights3 Multi-Payer Alignment on Value-Based Care Discussion Highlights4 Collecting Data to Ensure Equity in Payment Policy Discussion Highlights5 Center for Medicare & Medicaid Innovation Priority Actions and Implementation Considerations6 ConclusionReferencesAppendix A: Expert Panel ReviewAppendix B: Multi-Payer Alignment on Value-Based Care Discussion ProceedingsAppendix C: Collecting Data to Ensure Equity in Payment Policy Discussion ProceedingsAppendix D: Case Studies Developed for September 28, 2021, Meeting on Multi-Payer Alignment on Value-Based CareAppendix E: Meeting Participants for September 28, 2021, Meeting on Multi-Payer Alignment on Value-Based CareAppendix F: Meeting Agenda for September 28, 2021, Meeting on Multi-Payer Alignment on Value-Based CareAppendix G: G Meeting Participants for November 1, 2021, Meeting on Collecting Data to Ensure Equity in Payment PolicyAppendix H: Meeting Agenda for November 1, 2021, Meeting on Collecting Data to Ensure Equity in Payment Policy

Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume.

This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI's Strategic Refresh.