The Medicaid Innovation Accelerator Program
While it might appear that the Centers for Medicare and Medicaid Services (CMS) has borrowed a Hollywood script found on the editing room floor, the recently released Innovation Accelerator Program (IAP) is a serious health care collaborative program. The IAP is designed to help states reduce Medicaid spending, improve targeted admissions throughout the delivery care system and enhance patient outcomes. The program was launched July 14, 2014 and sent to all State Medicaid Directors, and perhaps anyone named Luke Skywalker or Han Solo.
We all know now that the Affordable Care Act was designed to reduce health care spending, improve patient medical experiences and outcomes in addition to holding ourselves accountable for our own health care goals. The IAP is established to more specifically assist states “through strategically targeted activities aimed at advancing the Medicaid delivery system and payment transformation,” according to the CMS press release.
This program is a little different than others in that it is actually built upon ideas and recommendations from health care providers, the National Governors Association and the National Association of Medical Directors. The central idea is to build consensus and collaboration on successful interventions of common challenges which in turn will move the national needle leading to healthy innovations, reduction in spending and happier patients.
The IAP is funded to make available $100 million on top of existing federal grants and seeks to expand the effectiveness of those programs by fueling them with additional resources and more pronounced collaborative practices. Presently, CMS is working with states through the Medicaid Innovation Start Initiative, Medicare-Medicaid Financial Alignment Model, and the State Innovation Model award. The IAP seeks to enable greater alignment between these programs as well as other programs being offered by private and public organizations.
CMS is touting the IAP as a new concept in health care thinking. “The IAP is designed to offer a new approach to addressing challenges collaboratively, leveraging best practices in driving innovation in the public and private sectors.” According to the CMS press release, the program seeks to “develop resources to support innovation through four key functions:
- Identify and Advance New Models – The IAP will investigate, develop and disseminate information and tools (including financial models to design payment strategies that strengthen incentives to achieve greater values) that will help implement promising models of care targeting the needs of Medicaid beneficiaries.
- Data Analytics – Ensuring real-time data-based approaches is core to successful and sustained delivery system reforms. The IAP will help states leverage new emerging data sources such as T-MSIS and the Medicaid / CHIP performance indicators, along with data sources from other payers and other programs to promote targets for intervention, identify best practices and maximize efficiencies.
- Improved Quality Measurement – The IAP will support alignment and integration of quality measurement across health care programs and initiatives to provide a more accurate and valid picture of quality to support and drive innovation within Medicaid and across payers.
- State to State Learning, Rapid Cycle Improvement and Federal Evaluation – The IAP will advance effective, efficient and timely dissemination of best practices in driving delivery system innovation, including vigorous support of rapid cycle improvement efforts underway in states with other partners.”
Through the IAP, CMS seeks to build upon recent state successful models that have assisted in producing efficiencies and effective program redesign strategies that have reduced cost and/or produced targeted reductions in readmissions. Examples of state successful models include:
- From Ohio – Obstetric hospitals throughout the state worked in a team-based approach on quality improvement projects at every hospital, and shared implementation strategies and results on monthly webinars, which in turn changed hospital policies. Result: A 30% reduction in early elective deliveries.
- From North Carolina – A transitional care program was established targeting multiple chronic condition beneficiaries. Success was achieved through comprehensive medication management, face-to-face management, education for patients and families and timely outpatient follow-up through a patient centered medical home that had been working directly with the transitional care team. Result: A 20% decrease in hospital readmissions.
- From Washington – The state developed and adopted a seven step approach to substance abuse and emergency department usage strategy. Result: ED visits decreased by 9.9%, frequent ED users decreased by 10.7%, ED visits related to narcotic prescriptions decreased by 24%. Savings – $34 million.
State health care innovation programs have been successful. CMS applauds recent state efforts and notes that while nationally Medicaid spending overall has grown in 2012 as a result of an increase in beneficiary status, the dollars or spending per enrollee has decreased by 1.9% from $6,768 to $6,641 annually.
Obviously, CMS is looking to keep this downward trend going. And, with programs like the IAP, we are sure to be heading in the right direction.
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