With so much drama circling healthcare policy at the moment, it can be hard to predict what the future holds but we know that the movement from volume to value will continue. Knowing this, on November 9, 2017, the Northern Virginia Health Policy Forum had Mimi Toomey provide updates on the CMS Innovation Center’s New Direction guiding principles and Request for Information (RFI). Ms. Toomey serves as the Deputy Director of the Policy and Programs Group at the Center for Medicare and Medicaid Innovation (CMMI).

Ms. Toomey began her comments by providing background on CMS’ Innovation Center statute, reviewing the goals of the organization and the process through which its research and recommendations are implemented through rulemaking. She detailed the composition of the Innovation Center and discussed the role each member group plays in testing and implementing innovative payment and service delivery models. Ms. Toomey connected the Innovation Center portfolio with broader CMS goals, discussed the alternative payment model development process, and touched on the Innovation Center’s range of impact.

Applied Policy’s President & CEO kicks off the discussion period by inquiring about the future of APMs given the low adoption by physicians to date.

Ms. Toomey’s presentation focused primarily, however, on the current CMS Innovation Center Models and CMS’ Putting People First program goals. They are categorized into four themes: empowering patients and doctors, state flexibility/local leadership, innovative approaches to improvement, and improving customer service. Specific models and initiatives presented addressed comprehensive primary care, oncology, state innovation, Maryland all-payer, Medicare diabetes prevention, Next Generation ACO, physician-focused payment, and transforming clinical practice.

During the event, Ms. Toomey also discussed the CMS Innovation Center’s New Direction Guiding Principles. These principles consider areas that need improvement and include choice and competition in the market, provider choice and incentives, patient-centered care, benefit design and price transparency, transparent model design and evaluation, and small-scale testing. They will guide the Center’s work moving forward.

Ms. Toomey concluded her event by highlighting the CMMI’s RFI which seeks input related to its new direction promoting patient-centered care and testing market-driven reforms. The new direction supports the established guiding principles and will manifest in models on expanded opportunities for participation in advanced APMs, consumer-directed care, physician specialty, prescription drugs, Medicare Advantage, state-based innovation, mental and behavioral health, and program integrity models. To submit comments and feedback, visit the website through November 20, 2017.

CMMI’s Mimi Toomey takes questions from the audience during the November Forum Event.

Following her presentation, there was a Q&A period where attendees inquired about Alternative Payment Models and post-acute and transitions of care, telehealth, the availability of interim report data, improving patient participation in the APM process, and the level of granularity for comment letters submitted during the RFI. Additional information from Ms. Toomey’s presentation can be found here. Be sure to revisit the public resources of the Center for Medicare & Medicaid Innovation and review the Alternative Payment Model Toolkit to learn more about model design and evaluation.

We would also like to extend a special thank you to our event sponsor Applied Policy. If you are interested in sponsoring a future Forum event, please email staff@novahealthpolicy.org.

Keep the conversation going after the event by visiting:

@NVAHealthPolicy @CMSGov @mimi_toomey

#AlternativePaymentModels #APMS #AAPMS #NVAHealthPolicy

Upcoming Events

Stay tuned for our upcoming Northern Virginia Health Policy Forum events:

  • The November networking event supporting the Carpenter’s Shelter Run for Shelter on November 18, 2017 – join the Forum’s team and run with us here!
  • The NVHPF’s 7th Annual Holiday Extravaganza, for the benefit of The Partnership for a Healthier Alexandria – get your tickets here!

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