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The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.
Patrick H. Conway (born 1974) is an American physician and an advocate of health system transformation and innovation in the public and private sector. He is a practicing pediatrician formerly serving at the Cincinnati Children's Hospital and Children's National Medical Center.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]
The Affordable Care Act mandated the creation of the Center for Medicare and Medicaid Innovation (CMMI) as part of the Centers for Medicare and Medicaid Services (CMS). It was created to test new "payment and delivery system models" to be used by "Medicare, Medicaid, and the Children's Health Insurance Program."
CMMI initiatives like the 2016 "Accountable Health Communities" (AHC) model have been created to focus on connecting Medicare and Medicaid beneficiaries with community services to address health-related social needs, while providing funds to organizations so that they can systematically identify and address the health-related social needs of ...
The suite of documents associated with a particular version of the CMMI includes a requirements specification called the Appraisal Requirements for CMMI (ARC), [2] which specifies three levels of formality for appraisals: Class A, B, and C. Formal (Class A) SCAMPIs are conducted by SEI-authorized Lead Appraisers who use the SCAMPI A Method Definition Document (MDD) [3] to conduct the appraisals.
HEDIS results must be audited by an NCQA-approved auditing firm for public reporting. NCQA has an on-line reporting tool called Quality Compass that is available for a fee of several thousand dollars. It provides detailed data on all measures and is intended for employers, consultants and insurance brokers who purchase health insurance for groups.