CMMI Evaluation Digest: November 2021

 

 

November 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: Medicare-Medicaid Financial Alignment Initiative (FAI) State Innovation Models (SIM) Initiative: Model Test Awards Round Two Rural Community Hospital Demonstration (RCHD)

 

Medicare-Medicaid Financial Alignment Initiative (FAI) Evaluation Reports -  Key Takeaways: CMS posted four reports on the FAI. This initiative aims to improve quality, reduce expenditures, and integrate primary, acute and behavioral health, and long-term services and supports for Medicare-Medicaid enrollees. Through this initiative and related work, CMS is partnering with states to test models intended to achieve those goals. CMS has released the sixth actuarial report for the Washington Managed Fee-for-Service Demonstration, a preliminary second evaluation report on the California Cal MediConnect Demonstration, a second evaluation report for the Illinois Medicare-Medicaid Alignment Initiative, and a preliminary fourth evaluation report on the Massachusetts One Care demonstration. The Washington actuarial report (which compares spending to a benchmark) shows gross reductions in Medicare expenditures through demonstration year 6. The California report shows significant increases in Medicare expenditures over the first three years of the demonstration; there are no utilization findings in this report. The Illinois and Massachusetts reports show no significant cumulative impact on Medicare expenditures (over the first three and four years of the demonstrations, respectively). The Reports: Washington Managed Fee-for-Service (MFFS) Final Demonstration Final Year 5 Preliminary Year 6 Savings Estimates (PDF) Massachusetts One Care - Preliminary Fourth Evaluation Report (PDF) Illinois Medicare-Medicaid Alignment Initiative - Second Evaluation Report (PDF) California Cal MediConnect - Preliminary Second Evaluation Report (PDF) Additional Supporting Materials: Model Page: Financial Alignment Initiative for Medicare-Medicaid Enrollees

 

State Innovation Models (SIM) Initiative: Model Test Awards Round Two Final Report - Key Takeaways: SIM Model Test states successfully designed and implemented payment and delivery models that yielded favorable impacts on spending and utilization. The flexibility of the SIM award allowed states to work within their existing health care landscape to complement ongoing state efforts and implement novel strategies. States increased the use of value-based payment models, particularly in Medicaid, and invested in primary care transformation and behavioral health integration, which increased provider capacity to provide quality care. States that addressed health-related social needs at the community and patient level also created connections between clinical and community resources. Many states sustained programs after the SIM award. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Final Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendices (PDF) - Methods and supplemental tables Model Page: State Innovation Awards Initiative

 

Rural Community Hospital Demonstration (RCHD) First Interim Evaluation Report - Key Takeaways: From 2005 to 2017, the RCHD achieved its goal of providing higher Medicare payments for covered inpatient hospital services. RCHD payments ranged from 30%-55% greater than what they would have received under the existing payment systems. RCHD hospitals continued to be in better financial condition, as evidenced  by having lower debt levels, more cash on hand, and higher Total Margins (including income from all sources, all payer revenue, investment gains). The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): First Interim Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Model Page: Rural Community Hospital Demonstration

 

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.