CMMI Evaluation Digest: October 2021

 

 

October 2021 This newsletter highlights recently released Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) evaluation reports and publications. You can access reports by going to the data and reports page of the Innovation Center website. Reports highlighted in this edition: Evaluation of the Maryland Total Cost of Care (MD TCOC) Model Evaluation of the Vermont All-payer Accountable Care Organization Model (VTAPM) Evaluation of the Pennsylvania Rural Health Model (PARHM)

 

Maryland Total Cost of Care (MD TCOC) Model Implementation Evaluation Report -  Key Takeaways: In its first two years, the MD TCOC Model has engaged a wide range of providers to begin transforming care throughout the state. The model has continued the hospital global budgets that incentivize reductions in avoidable acute care while extending incentives and supports beyond the hospital to include post-acute providers, primary care, and community organizations. Future evaluations will assess whether care transformation continues, expands in reach, and succeeds in reducing Medicare total cost of care while improving quality of care and population health for all Marylanders.   The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Implementation Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Model Page: Maryland Total Cost of Care (TCOC) Model

 

Vermont All-payer Accountable Care Organization Model (VTAPM) First Evaluation Report - Key Takeaways: While the VTAPM failed to achieve its all-payer and Medicare scale target goals, in its first two performance years, the Model achieved statistically significant Medicare gross spending reductions at both the Accountable Care Organization (ACO) and state levels, as well as Medicare net spending reductions at the state level. There were declines in acute care stays (at the ACO and state levels) and in 30-day readmissions at the state level. These decreases in utilization and spending may reflect rising spending in the comparison groups and relatively flat spending in the VTAPM groups that began in the baseline period and continued into the first two performance years.   The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): First Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendices (PDF) - Methods and supplemental tables Model Page: Vermont All-Payer Accountable Care Organization (ACO) Model

 

Pennsylvania Rural Health Model (PARHM) First Annual Evaluation Report - Key Takeaways: The approach to payment reform in this Model attracted a range of participants from a variety of hospital types (e.g., critical access hospitals, prospective payment system, independent, system-affiliated, and varying financial status). However, hospital participation has been lower than anticipated, resulting in challenges to achieving scale targets and a smaller share of revenue covered by the global budget. Medicare’s fixed, biweekly payments helped participants manage fluctuations in volume and provided financial stability. Additionally, while the Model contributes to short-term financial stability, independent rural hospitals continue to struggle with long-term sustainability. Some hospitals opted for long-term financial stability through system acquisition and mergers. Large cost savings also may not be feasible in the Model due to the limited timeline to realize significant spending reductions and to the hospitals’ tight operation margins.   The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): First Annual Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendices (PDF) - Methods and Supplemental Tables Model Page: Pennsylvania Rural Health Model (PARHM)

 

The CMS Innovation Center maintains a portfolio supporting the development and testing of innovative health care payment and service delivery models. It performs evaluations of these models and makes the results available to the public. Bringing you the latest CMS Innovation Center Evaluation Results: Watch out for future issues of our Evaluation Digest,  check out the CMS Innovation Center website, and follow us on Twitter.