Billions for Health Care Ideas
Written by Editor   
Tuesday, August 19, 2014 04:35 PM

The Affordable Care Act was supposed to mend what President Barack Obama called a broken healthcare system, but its best-known programs -- online insurance and expanded Medicaid for the poor -- affect a relatively small portion of Americans.

A federal office you've probably never heard of is supposed to fix healthcare for everybody else.  The law created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse.   Its programs touch millions of patients. Hundreds of organizations have gotten money. More than $2 billion has been doled out or committed since 2011.

George Washington University's was given $1.9 million to improve care and cut costs for at-home dialysis patients. CareFirst BlueCross BlueShield's was given a $24 million grant to reduce unnecessary hospital visits for chronically ill Medicare patients. The Johns Hopkins University got $19.9 million to improve care for East Baltimore's chronically sick and mentally ill. An Asian-American community group got $2.7 million to help low-income Californians navigate the medical system. The University of Tennessee got $3 million to help ensure repeat hospital patients in Memphis stay on their medications after discharge. Intermountain Health Care got $9.7 million to test software that forecasts the best ways for caregivers to interact with patients.

Many efforts don't just involve the elderly Medicare and poor Medicaid patients in HHS' primary insurance programs. Six states got up to $45 million each to involve commercial insurers and their members as well as government programs in trials to improve health and control costs.

The office's goal is nothing less than healthcare's three pots of gold over the rainbow: making medicine less of an ordeal, improving patients' health, and controlling the spiraling costs that burden taxpayers, employers, and consumers.  With a staff of 265 and growing, CMMI must not only administer ACOs and other reimbursement tests that reward quality care at lower cost. It also manages hundreds of grants and dozens of contractors hired to monitor and evaluate the programs.  Projects tend to focus on people with expensive diseases such as cancer, diabetes, heart failure, and schizophrenia.