Rocco J. Perla is an assistant professor of health services research at the University of Massachusetts Medical School, in Worcester. At the time this work was completed, he served as president of Health Leads, in Boston, Massachusetts.
Hoangmai Pham is vice president for provider alignment solutions at Anthem Inc., in Indianapolis, Indiana.
Health Aff (Millwood). 2018 Feb;37(2):213-221. doi: 10.1377/hlthaff.2017.1109.
Congress established the Center for Medicare and Medicaid Innovation (CMMI) to design, test, and spread innovative payment and service delivery models that either reduce spending without reducing the quality of care or improve the quality of care without increasing spending. CMMI sought to leverage these models to foster market innovation and accelerate the transformation of payment and care delivery to achieve the Triple Aim of better health, better care, and lower cost. This article provides a perspective on the design and execution of CMMI's five initial models, the resulting outcomes and lessons, and how their core concepts evolved within and spread beyond CMMI. This experience yields three key insights that could inform future efforts by CMMI and public and private payers, including model designs and policy decisions. These insights center on the need for iterative testing and learning guided by market feedback, more realistic time frames to demonstrate impact on cost and quality, and greater integration of models.
国会设立了医疗保险和医疗补助创新中心（CMMI），旨在设计、测试和推广创新的支付和服务提供模式，这些模式既能降低成本而不降低医疗质量，又能提高医疗质量而不增加支出。CMMI 试图利用这些模式来促进市场创新，并加速支付和医疗服务的转型，以实现更好的医疗保健、更好的护理和更低的成本的三重目标。本文提供了对 CMMI 最初的五个模型的设计和执行、所产生的结果和经验教训，以及它们的核心概念如何在 CMMI 内部和外部演变和传播的观点。这一经验带来了三个关键的见解，可以为 CMMI 以及公共和私人支付者提供未来的努力，包括模型设计和政策决策。这些见解集中在需要通过市场反馈进行迭代测试和学习，更现实的时间框架来展示对成本和质量的影响，以及更大程度的模型整合。
