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Medicare Seeks Proposals to Improve Quality Of
Health Care
Sept. 9, 2005 Medicare is seeking proposals for a
five-year project to find ways to identify, develop, test and
disseminate major and multifaceted improvements to the health care
systems at the area or regional level. The projects will not receive
initial funding but demonstration financing will be through Medicare
payments for services.
The Centers for Medicare & Medicaid Services (CMS)
announcement today says the demonstration - part of their Medicare
Health Care Quality Demonstration program - seeks to improve quality
while increasing efficiency through major, regional-level health care
system redesign.
Medicare demonstrations are opportunities for
providers to provide services to Medicare beneficiaries -- either
services over and above the existing Medicare benefit package or
services that are paid differently or under different conditions from
the regular Medicare program.
By modifying payment systems and providing
incentives for better quality and lower costs, health care organizations
and their communities will have new financial support to adopt and use
decision support tools (e.g., evidence-based guidelines, shared
decision-making tools), reduce unwarranted variation in practice,
measure outcomes and enhance cultural competence in the delivery of
care. These reforms hold the potential for significant improvements in
quality and outcomes.
This is a major initiative to use innovative
payments to improve health and reduce costs for everyone in an area, not
just for Medicare beneficiaries but for all Americans, said CMS
Administrator Mark B. McClellan, M.D., Ph.D. We are allowing providers
and communities to take advantage of Medicare payment reforms to
redesign care delivery from the ground up, where they have the
opportunity to structure that care and payment in a way that focuses on
outcomes.
Projects and strategies that may be approved under the demonstration
will be expected to demonstrate how they achieve safety, effectiveness,
efficiency, patient-centeredness, timeliness and equity: the six aims
for improvement in quality identified by the Institute of Medicine in
its Crossing the Quality Chasm. Demonstrations that achieve such
improvements in quality, including efficiency, can qualify for greater
Medicare payments to the participating health care providers in the
area.
Physician groups, integrated delivery systems, or
regional coalitions of such groups or systems are invited to apply.
Under the Health Care Demonstration, we will be
able to make payments across providers and settings to help achieve the
improvements in population outcomes we know are possible to achieve in
our health are system, said McClellan.
Applicants may propose a variety of payment
methodologies to cover demonstration services and to provide incentives
for improving quality and efficiency of care, provided that the proposal
achieves budget neutrality.
Proposals will be considered in two groups.
Applicants wishing to be considered in the first group must submit their
proposals no later than January 30, 2006. However, given the breadth of
this project, many system redesigns will take longer to develop.
Therefore, applicants wishing to be considered in the next round of
application reviews should submit a letter of intent no later than
January 30, 2006. Applications for the second group will be due
September 29, 2006.
For further information, please visit the CMS web
site at
http://www.cms.hhs.gov/researchers/demos/mma646/.
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