Is CMS innovation center overzealous, redundant?

The new Center for Medicare and Medicaid Innovation (CMMI) will need three to five years to know whether most of its three dozen test initiatives to lower healthcare costs and improve quality are bearing fruit, the CMMI director told a congressional committee Wednesday.

In other cases, CMMI might know in one or two years whether an innovation model should be tested more broadly in Medicare, Medicaid or the Children's Health Insurance Program (CHIP), Richard Gilfillan, M.D., told the Senate Finance Committee in prepared testimony.

Given the three- to five-year timeframe, Sen. Richard Hatch (R-Utah) suggested the innovation center study the effect its initiatives are having while they are still going on.

Hatch praised the concept of healthcare innovation but questioned whether CMMI lacked clear focus and had bitten off more than it could chew.

"It seems to me that CMMI would function best if it would pick a few initiatives--such as accountable care organizations (ACOs) or bundled payment--and really devote the time to those initiatives to make sure they actually work and have the intended consequences of lowering costs and increasing quality and efficiency," he said in a statement. "Instead, I fear you are trying to do too much at one time."

He also questioned CMMI staff salaries, noting General Accountability Office findings that nearly half of the 184 on staff sit at the top of the federal pay scale, and the center's decision to buy expensive treadmill desks for staffers.

Meanwhile, Sens. Johnny Isakson (R-Ga.) and Chuck Grassley (R-Iowa) questioned whether CMMI was going over ground already covered by the Centers for Medicare & Medicaid Services, Politico reported.

They pointed to a report last year in which the GAO said the innovation center needs to work harder at making sure it's not overlapping with the rest of CMS.

Sen. Max Baucus (D-Mont.) urged patience. CMMI's goal is to identify and push through reform more quickly than the decade similar tests took in the past, he said in a statement.

"Some of the tested models will be successful and others won't, but we cannot be afraid of missteps," he said. "We must continue trying new ideas, learning from mistakes, and building on our successes. That's how we find what works."

To learn more:
- download Gilfillan's testimony (.pdf)
- download Hatch's statement (.pdf)
- read the Politico article
- here's Baucus' statement (.pdf)