The Center for Medicare and Medicaid Innovation (CMMI) has released its 2024 Report to Congress, showcasing significant strides in healthcare transformation through value-based care models and initiatives. Since 2022, CMMI has launched nine models targeting critical areas like maternal health, behavioral health, and primary care. These models reflect CMMI's commitment to achieving equitable outcomes through high-quality, person-centered care while reducing healthcare costs.
By the Numbers:
Over 57 million beneficiaries impacted
192,000+ participating healthcare providers and plans
37 active models and initiatives
52 evaluation reports posted
130+ hosted audience engagement events
Strategic Focus Areas
The report highlights five core objectives:
Driving accountable care
Advancing health equity
Supporting innovation
Addressing affordability
Partnering for system transformation
Achievements:
Expanded ACO REACH participation from 53 ACOs to 132 ACOs, covering 2.1 million lives
Launched Models targeting underserved communities through programs like GUIDE for dementia care
Implemented new payment adjustments to support care for underserved populations
Advanced multi-payer alignment through state-based initiatives
Looking Ahead, CMMI continues to work toward its goal of having all Medicare and most Medicaid beneficiaries in accountable care relationships by 2030. The focus remains on scaling successful models, addressing health disparities, and fostering partnerships for sustainable healthcare transformation.
Areas to Watch:
Mandatory vs. Voluntary Models
CMMI has been implementing some mandatory models like TEAM and IOTA
Historical precedent suggests potential changes around participation models, similar to the 2017 changes to the CJR model that made it voluntary for many participants.
State Flexibility
Models like AHEAD and MCP emphasize state partnerships
Expansion of state flexibility and control, possibly through increased State Innovation Waivers
Value-Based Care Approach
The strong push toward accountable care with 57M+ beneficiaries in value-based models
While value-based care has bipartisan support, implementation approaches may shift toward market-driven solutions.
Programs Likely to Remain Stable:
Medicare Shared Savings Program (MSSP) - Has broad bipartisan support
Primary Care Models - Align with cost reduction goals
Rural Health Initiatives - Address consistent bipartisan priority
Areas That May See Changes:
Health Equity Initiatives - May shift focus to market-based solutions
Mandatory Model Requirements - Could become adjusted
Multi-payer Alignment Efforts - May emphasize private sector leadership
Administrative Considerations:
Model Timelines: Many current models extend through 2026-2030
Existing Contracts: Legal obligations and participant agreements limit immediate changes
Budget Impact: Any changes would need to align with budget considerations
Key Takeaway:
While administrative changes can affect healthcare innovation priorities, CMMI's core mission of testing payment and service delivery models to reduce costs while maintaining or improving quality will likely continue, though potentially through different approaches and mechanisms.
Practical Guidance:
Providers should maintain flexibility in value-based care strategies
States should prepare for potential increased autonomy in program design
Healthcare organizations should focus on demonstrable cost savings alongside quality metrics
Industry partners should prepare for possible shifts in compliance requirements
Note: This analysis is based on historical patterns and policy trends. Actual changes depend on multiple factors, including congressional action, stakeholder input, and existing program commitments.
If you have specific model questions, reach out to us at info@benevolencehealthadvisors.com
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