New Ways to Deliver Care: The Center for Medicare and Medicaid Innovation promises cost-cutting ideas

A third project creates a state option under which Medicaid patients who have at least two chronic conditions can designate a provider as a “health home” that would help coordinate care. States that go this route will receive enhanced financial resources from the federal government to support Medicaid health homes.

The center, which is part of the Centers for Medicare and Medicaid Services, also announced an upcoming initiative in which states can apply for contracts to support development of new models aimed at improving the quality, coordination and cost-effectiveness of care for beneficiaries who are eligible for both Medicare and Medicaid, also known as “dual eligibles.”

Involvement from Specialists

Whether and how specialists like otolaryngologists fit into these experiments is unclear. The center did not respond to requests for an interview.

“The idea of delivering integrated, coordinated care for patients is critical, but it’s important that we look at the subspecialty aspect of patients’ care and make sure that this does not in any way preclude patients from seeing specialists,” said Pete Batra, MD, associate professor and co-director of the Comprehensive Skull Base Program in the department of otolaryngology-head and neck surgery at the University of Texas Southwestern Medical Center in Dallas.

As the center forges ahead, physician input is crucial to the positive development of new patient care models, said American Medical Association (AMA) President Cecil Wilson, MD, in a November statement. “All the new models of care currently being designed, from medical homes and bundling to accountable care organizations, can and should be physician-led initiatives so that the programs are designed with patients’ health care needs front and center,” he said. “Physicians from different types of practices and practice sizes should be able to participate so that all patients reap the benefit of new ways that health care is delivered.”

Once the center’s projects are up and running, the Department of Health and Human Services is allowed to expand their scope and duration if it deems that doing so would reduce spending without hurting quality or improve quality and reduce spending. The department could make expansions through its regular rule-making process.