CMS Innovation Center Evaluation Digest - October 2020

 

 

 

October 2020 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: Oncology Care Model (OCM) Comprehensive Primary Care Plus (CPC+) Model Accountable Care Organization (ACO) Investment (AIM) Model

 

Oncology Care Model (OCM) Second Annual Evaluation Report Performance Periods 1-3 Key Takeaways: OCM leverages enhanced payments in the form of a per-beneficiary $160 Monthly Enhanced Oncology Services (MEOS) payment and performance-based payments (PBPs) to incentivize practice change. OCM aims to achieve cost savings through improving processes such as care coordination and adherence to national clinical guidelines. Many OCM practices report focusing on patient education and outreach and same-day care to avoid Emergency Department visits and hospitalizations. Episode payments for high-risk cancers declined, but increases in episode payments for low-risk cancers offset these impacts, leading to a non-significant overall estimate for Performance Periods 1-3. When model payments from the first two performance periods were included (MEOS and PBP), OCM resulted in net losses for Medicare. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Second Annual Evaluation Report Performance Periods 1-3 (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: CMS Perspective (PDF) - New resource! CMS’s review of the evaluation report findings and discussion of selected next steps. Appendices (PDF) - Methods and additional tables related to findings discussed in the report Model Page: Oncology Care Model

 

Comprehensive Primary Care Plus (CPC+) Second Annual Evaluation Report Key Takeaways: In the second year of the initiative, practices used the CPC+ supports to build on their progress from the first year and continue to make important changes in care. These changes included adding care management processes and staff to help patients with complex needs manage their conditions, integrating behavioral health care into their practices, and establishing formal processes with hospitals and emergency departments to improve care transitions. Although practices made beneficial changes to care delivery, many indicated that additional payments, more timely and user-friendly data feedback, and stronger health IT support would be helpful in achieving the five Comprehensive Primary Care Functions. As expected at this stage of care delivery changes, there were few favorable effects on cost, service use, and quality for Medicare Fee For Service beneficiaries. Future reports will examine the remaining three years of the model, focusing on how supports and practice transformation unfold, effects on physician experience, and whether effects on patient outcomes emerge as CPC+ practices deepen and expand care delivery changes. Finally, reports will discuss implications for sustainability and spread of the model. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Second Annual Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: CMS Perspective (PDF) - New resource! CMS’s review of the evaluation report findings and discussion of selected next steps. Appendices (PDF) - Methods and additional tables related to findings discussed in the report. Methods discussion include discussion on innovative approach: Bayesian Causal Forests Supplemental Volume (PDF) - Features in-depth discussion of results related to selected topics including CPC+ stakeholder involvement, how practices are transforming care, beneficiary experiences, and effect of CPC+ on expenditures, service use, and quality of care Model Page: Comprehensive Primary Care Plus (CPC+) Model Related Model Pages: Comprehensive Primary Care Initiative, Primary Care First Model Options

 

Accountable Care Organization (ACO) Investment Model (AIM) Final Evaluation Report - Three Performance Years Key Takeaways: Selected key takeaways from the AIM final report include: AIM ACOs were located in areas with greater health care needs and less access to accountable care. Many AIM ACOs indicated that AIM funds were critical to their formation. AIM ACOs were successful in reducing total Medicare spending and related utilization without decreasing the quality of care they provided. AIM generated net savings to Medicare during each of the three performance years. Most AIM ACOs ended participation in the Shared Savings Program (SSP) at the end of 2018. However, many of their providers partially or fully joined other SSP ACOs in 2019. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Final Evaluation Report - Three Performance Years (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: CMS Perspective (PDF) - New resource! CMS’s review of the evaluation report findings and discussion of selected next steps. Appendices (PDF) - Discussion of methods and supplemental tables including ACO level results Model Page: Accountable Care Organization (ACO) Investment Model (AIM) Related Model Page: Community Health Access and Rural Transformation (CHART) Model

 

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.