CMS puts thinking cap on, will launch new innovation center

The Centers for Medicare and Medicaid Services will spend $10 billion during the next nine years on research into how to reduce health care costs while improving quality of care.

The Centers for Medicare and Medicaid Services will spend $10 billion during the next nine years on research into how to reduce health care costs while improving quality of care, its top official has said.

CMS Administrator Dr. Donald Berwick outlined his goals and approach for the Center for Medicare and Medicaid Innovation this week during a conference at the Brookings Institution’s Engelberg Center for Health Care Reform.

Under the new health reform law, CMS will open the research center in January 2011 to investigate alternatives to its traditional fee-for-service model for paying doctors. The choices might include models in which doctors are paid a monthly fee per patient to provide preventive and urgent care rather than being paid a fee each time service is rendered. CMS has the authority to implement such changes without asking for Congress' approval.


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Berwick said his goal is to honor what he called the center's triple aim in the upcoming research: improved health, improved quality of care and reduced costs.

“The third part of the triple aim is lower cost, reduction of cost, measured as you wish, per capita or otherwise,” Berwick said. “And I want to make it very clear: It’s reduction of cost without harming a hair on anyone’s head. No one gets harmed — no patient, no community, no loved one.”

Berwick also described his approach as a reflection of medicine as one of many shareholders in the field of public enterprises, acknowledging that taxpayer-funded medical care is competing for public funding along with schools, the environment, transportation and other public endeavors.

“Viewing ourselves as a shareholder makes us less entitled to any share we can get and should make us more interested in prudent approaches to the reduction of cost through improvement itself,” Berwick said.

He also announced that Dr. Richard Gilfillan will be acting director of the new innovation center. Gilfillan previously directed performance-based payment policy at CMS and was a health care consultant at Geisinger Consulting Group.