In the ever-evolving landscape of health care, the need for innovative solutions to improve patient care while managing costs has never been more critical. The Centers for Medicare and Medicaid Services (CMS) Innovation Center plays a pivotal role in this endeavor.
On September 18, 2024, the Society for Women’s Health Research (SWHR) welcomed Dr. Susannah M. Bernheim, Chief Quality Officer and Acting Chief Medical Officer of the CMS Innovation Center to its quarterly Policy Advisory Council meeting, where Dr. Bernheim shared insights into the center’s mission and its commitment to enhancing health care delivery.
The CMS Innovation Center
According to Dr. Bernheim, the primary goal of the CMS Innovation Center is to “test innovative payment and service delivery models that aim to reduce program expenditures while preserving or enhancing the quality of care provided to individuals.” The CMS Innovation Center engages with hospital systems, safety net providers, suppliers, payers, and community-based organizations across the country to test payment and service delivery models focused on either improving quality, reducing cost, or both.
The CMS Innovation Center currently has five strategic objectives: Drive Accountable Care; Advance Health Equity; Support Innovation; Address Affordability; and Partner to Achieve System Transformation.
Advancing Health Equity
Dr. Bernheim emphasized the importance of evaluating models specifically for their impact on health equity. To advance health equity, the CMS Innovation Center is focusing its efforts in key areas like developing new models to address health equity and social determinants of health; boosting the number of beneficiaries from underserved communities receiving care through value-based payment models; assessing models for their effects on health equity and sharing findings and insights to guide future initiatives; and improving data collection and intersectional analyses for groups defined by demographic factors (including race, ethnicity, geography, language, disability, and sexual orientation/gender identity) to identify care gaps and design effective interventions.
Innovative Models and Ties to Women’s Health
Dr. Bernheim shared details about several models currently being explored by the CMS Innovation Center. While these models have broader impacts on population health, several of them overlap with the work of SWHR and can promote positive outcomes for women’s health.
The Making Care Primary (MCP) Model was recently launched in July 2024. Being tested across eight states, the purpose of this model is to provide a pathway for prospective payment to support comprehensive primary care while also ensuring positive patient care. By addressing challenges in care coordination, this model has the potential to improve patient outcomes.
Meanwhile, through the Transforming Maternal Health (TMaH) Model, CMS will work with up to 15 state Medicaid agencies to carry out elements of the model, which is designed to improve maternal and infant health outcomes. This model is centered around increasing access to care and workforce professionals such as midwives and doulas, implementing quality improvement measures to make the birthing experience safer for mothers and babies, and improving screening and referral protocols for perinatal patients. Through its work in the Coalition for Maternal Therapeutics, SWHR is supportive of efforts to improve the health and wellbeing of perinatal patients.
Lastly, the Guiding an Improved Dementia Experience (GUIDE) Model, which was also launched in July 2024, will test how the quality of life for patients with dementia may be impacted by a comprehensive package of care coordination and management, support and education for caregivers, and respite services with no cost-sharing for caregiving in patients’ homes, adult day centers, and 24-hour care facilities. Alzheimer’s disease is the fifth leading cause of death for women and men ages 65 and over, and SWHR’s Call to Action, “Breaking Down the Burden of Alzheimer’s Disease for Women”, highlights the need for an all-encompassing approach to the disease.
These are just a few examples of models currently being explored by the CMS Innovation Center. Each initiative highlights the significance of customized health care solutions that cater to the unique needs of Medicare and Medicaid populations, particularly women, who frequently encounter distinct health and caregiving challenges. The collaboration and innovation promoted across these models have the potential to advance a care system that effectively addresses the specific needs of women throughout their life stages.
Driving Meaningful Change
Dr. Berhnheim left the SWHR Policy Advisory Council with valuable information on the future of the CMS Innovation Center and how it is working to improve patient health outcomes and access to care. By testing new models and collaborating with various stakeholders, the CMS Innovation Center is driving meaningful change in the health care system by paving the way for a more equitable and efficient health care system.
For those wanting to stay informed about the CMS Innovation Center’s initiatives, you can visit their website to learn more about their ongoing efforts to advance women’s health and overall health care equity.