CMS Innovation Center Evaluation Digest - December 2020

 

 

December 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: Home Health Value‐Based Purchasing (HHVBP) Model Comprehensive End-Stage Renal Disease Care (CEC) Model Comprehensive Care for Joint Replacement (CJR) Model

 

Home Health Value‐Based Purchasing (HHVBP) Model Third Annual Evaluation Report Key Takeaways: The first three years of the implementation of HHVBP (2016-2018) have resulted in Medicare savings of $141 million (1.2% decline relative to the comparison group) and improvements in quality. These impacts were observed both during 2018, the first year for quality based payment adjustments, and in the initial two years of the model. We will continue to evaluate the impact of HHVBP on quality and Medicare spending as the maximum payment adjustments become larger each year from 2019-2022. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Third Annual Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Technical Appendices (PDF) - Methods and supporting tables Model Page: Home Health Value-Based Purchasing Model

 

Comprehensive End-Stage Renal Disease Care (CEC) Model Performance Year 3 Annual Evaluation Report Key Takeaways: The CEC Model is the first Medicare Accountable Care Organization (ACO) model that targets a particular clinical population. Results from the first three performance years of the CEC Model show specialty - oriented ACOs for beneficiaries with End-Stage Renal Disease (ESRD) can reduce spending while improving key quality outcomes. Findings from the CEC evaluation can inform the development of future models focused on kidney disease as well as specialty-oriented ACO models focused on other chronic conditions. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Go directly to the Executive Summary (PDF) Additional Supporting Materials: CMS Perspective (PDF) - CMS’s review of the evaluation report findings and discussion of selected next steps. Appendices (PDF) - Detailed discussion of methodology approach Model Page: Comprehensive End-Stage Renal Disease Care Model Related Model Pages: ESRD Treatment Choices Model, Kidney Care Choice Model

 

Comprehensive Care for Joint Replacement (CJR) Model Third Annual Evaluation Report Key Takeaways: During the first three years of the model, mandatory CJR hospitals achieved a statistically significant decrease in average payments for all lower extremity joint replacements (LEJRs) (inpatient and outpatient) relative to the control group. After accounting for net reconciliation payments, estimated net savings for these LEJRs was $61.6 million (a savings of 2% of the baseline). The gross reduction in payments was due to decreases in institutional post-acute care use. Measures of quality of care improved or were maintained under the CJR model. Hospital interviewees reported strategies to coordinate care throughout the episode, however the amount of control hospitals had over care redesign was influenced by hospital resources and market conditions. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Third Annual Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: CMS Perspective (PDF) - CMS’s review of the evaluation report findings and discussion of selected next steps. Appendices (PDF) - Methods, survey instruments, and supplemental data tables Provider Experiences Report: Case Studies from Three Mandatory Markets (PDF) Video: Overview of the 3rd Evaluation Report (6 minutes) Model Page: Comprehensive Care for Joint Replacement 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.