In the past several years, the Center for Medicare & Medicaid Innovation (CMMI), part of the Centers for Medicare & Medicaid Services (CMS), has designed and implemented demonstration projects and models to try new ways of paying providers to deliver health care to people with Medicare. These tests of new designs attempt to see if there are ways providers can be paid that will increase the quality of care people receive while either keeping costs stable or, ideally, lowering them.
The sheer number and diversity of these CMMI models can make it difficult for researchers, advocates, and the general public to see and compare their designs and outcomes. The Kaiser Family Foundation (KFF), a nonpartisan source of health policy analysis, has made this easier by collecting resources on each model on a new site: Medicare Delivery System Reform: The Evidence Link. Through The Evidence Link, users can compare similar models, understand their costs and potential or realized savings, and discover more about the participating populations, from beneficiaries to care providers.
For example, for Accountable Care Organizations (ACOs)—one of the more common models—users can start on the main page; then go to a separate ACO page to read more about the design of the model with its intended benefits; find a FAQ that explores designs, eligibility, and savings; and compare ACO models to one another with a side-by-side comparison tool.
The ACO page includes evidence that ACOs have saved the Medicare program money under limited circumstances. ACO models that put providers on the hook for savings and outcomes save more, while models that do not put the providers at risk appear to cost more than having no model at all. The Evidence Link includes similar pages for other model types—Medical Home Models and Bundled Payment Models.
ACOs and Medical Homes provide care for approximately 21% of all people with Medicare. The number of beneficiaries impacted by Bundled Payment Models is currently unavailable.
The Medicare Rights Center is encouraged by the potential of these innovative payment systems, but has repeatedly called for CMS to ensure that there are sufficient protections in place to ensure that people with Medicare are receiving high-quality care and achieving the outcomes they need to thrive, even in models that are being tested. The Evidence Link can help organizations like Medicare Rights advocate for solutions that strengthen and protect the Medicare program for the benefit of older adults and people with disabilities.
Learn more about the Medicare Rights Center’s consumer protections that should be included in CMMI models.
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