CMS—Engaging Multiple Payers in Payment Reform

• Published in: JAMA : the journal of the American Medical Association Vol. 311; no. 19; pp. 1967 - 1968
• Main Authors: Rajkumar, Rahul, Conway, Patrick H, Tavenner, Marilyn
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 21.05.2014
• Subjects: Accountable care organizations; Centers for Medicare and Medicaid Services (U.S.); Child; Child Health Services - economics; Cost Control; Delivery of Health Care - trends; Government agencies; Health Care Costs - trends; Health care delivery; Humans; Insurance, Health - economics; Medicaid - economics; Medicare - economics; Organizational Innovation; Patient Protection & Affordable Care Act 2010-US; Payment systems; Reforms; Reimbursement, Incentive; United States; United States
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.2014.3703

The Affordable Care Act created the Center for Medicare and Medicaid Innovation (Innovation Center) to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) and to enhance the quality of care that Centers for Medicare & Medicaid Services (CMS) beneficiaries receive. CMS is testing more than 20 models under this authority that create new incentives for clinicians and organizations that deliver medical care through CMS programs to deliver better care at lower cost. CMS is also supporting a variety of state efforts to create new incentives for these clinicians and organizations through the Medicaid and CHIP pro- grams. All of these models share a common pathway for success: they hinge on getting clinicians and health care organizations to manage the health of populations and to act as good stewards of health care resources. Here, Rajkumar et al examine CMS' engagement of multiple payers in payment reforms.