CMMI seeking safety-net providers for new wave of models that focus on health equity

The Biden administration is searching for ways to get more safety-net providers to participate in value-based care to reach patients in vulnerable populations, officials said.

Leaders with the Center for Medicare & Medicaid Innovation spoke during the Healthcare Payment Learning and Action Network summit on Wednesday on the need to boost health equity in payment models. The center made health equity a major priority in its latest strategic refresh of payment models released back in October.

“We will ask ourselves how this model affects equity … and what resources are needed including financial and human capital are needed,” said Dora Hughes, the chief medical officer for CMMI during the summit.

Part of that evaluation is to look at how to entice safety-net providers into value-based care models, which can be costly propositions for those who operate on thin profit margins.

CMMI needs to provide “options and tools for providers to [give] multiple levels of risk to bring into the fold,” Hughes said.

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The refresh has caused CMMI to take another look at how models are not just structured but who gets to participate.

“For one of our models, we looked back at 900 applications to see who was rejected and why,” Hughes said.

She cautioned that newer models won’t be launched until 2023 at the earliest as they must be reviewed and get cleared.

“It does take some time to get new models out the door,” she said. “However, we are looking at some of our current models to the extent we can modify participation agreements or changes.”