CMMI Evaluation Digest June 2022

 

 

June 2022 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: Part D Enhanced Medication Therapy Management (MTM) Model: Fourth Evaluation Report Medicare Care Choices Model: Fourth Annual Report Home Health Value-Based Purchasing Model: First Five Performance Years (2016-2020) Evaluation Report

 

Part D Enhanced Medication Therapy Management (MTM) Model Fourth Evaluation Report - Key Takeaways: The Enhanced Medication Therapy Management (MTM) Model, which began in January 2017, is a 5-year Model that tests whether modifications to traditional MTM requirements incentivize better medication management interventions, and thereby lead to improved therapeutic outcomes and reductions in Medicare expenditures. There continue to be no statistically significant impacts on Medicare Parts A & B expenditures for the overall enrollee population in Model-participating plans. In addition, Medicare’s prospective and performance-based payments to sponsors for the Model continue to be larger than the non-significant decreases in Medicare Parts A & B expenditures. Findings from subgroup analyses suggest that enrollees eligible for the low-income subsidy and enrollees with medically complex profiles did not benefit more from the Model compared to the overall enrollee population. Despite high eligibility and service receipt rates for medically complex enrollees, there were no significant impacts on Medicare Part’s A & B expenditures for this subgroup. Setting-specific impacts were generally similar for the enrollee subgroups and all-enrollee cohort. There were decreases in inpatient expenditures and admissions related to Ambulatory Care Sensitive Conditions for both the medically complex subgroup and the all-enrollee cohort. The Two Page Overview: Findings At-a-Glance (PDF) The Report (includes an Executive Summary): Fourth Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendix A: Profiles of Participating Sponsors and their Interventions (PDF) Appendix B: Methods and Supporting Analyses (PDF) Model Page: Part D Enhanced Medication Therapy Management (MTM) Model Medicare Care Choices Model Fourth Annual Report - Key Takeaways: The Medicare Care Choices Model (MCCM) tested whether offering eligible beneficiaries the option to receive supportive services at the end of life without forgoing payment for treatment of their terminal conditions (which is required to enroll in the Medicare hospice benefit) improved the quality of care, increased beneficiaries’ satisfaction, and reduced Medicare expenditures. Outcomes generally aligned with the expectations of the model. Specifically, MCCM beneficiaries were more likely to enroll in the Medicare hospice benefit than matched comparison beneficiaries, less likely to use hospital services and other health care services, and more likely to receive better-quality end-of-life care in the period between enrollment in MCCM and death. Decreased use of resource-intensive services, driven by earlier enrollment in the hospice benefit, resulted in lower Medicare expenditures. These findings might not generalize to other settings, however, given the small number of hospices that participated in MCCM and the small percentage of eligible beneficiaries that enrolled. The Two Page Overview: Findings At-a-Glance (PDF) The Report (includes an Executive Summary): Fourth Annual Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendix: Methods and Supporting Analyses (PDF) Model Page: Medicare Care Choices Model Home Health Value-Based Purchasing Model First Five Performance Years (2016-2020) Evaluation Report - Key Takeaways:  The Home Health Value‐Based Purchasing (HHVBP) Model provides financial incentives to home health agencies for quality improvement based on their performance relative to other agencies in their state. The first five years of the implementation of the original HHVBP Model have resulted in cumulative Medicare savings of $949.2 million, a 1.6% decline relative to the 41 non-HHVBP states, as well as improvements in quality. These impacts were observed during 2020, the third year for quality-based payment adjustments, as well as the first four years of the model. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Fifth Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendix: Methods and Supporting Analyses (PDF) Model Page: Home Health Value-Based Purchasing 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.