CMMI chief reaffirms commitment to value-based care

In the opening plenary of the NAACOS 2021 Spring Conference, Liz Fowler, MD, PhD, the newly minted director of the Center for Medicare and Medicaid Innovation (CMMI), says the organization is committed to value-based care.

She said that a goal of the Affordable Care Act (ACA), which created the center, was to not only provide the uninsured with coverage but also to move the healthcare system away from fee-for-service and toward value-based care.

“It was not a side conversation; it was an equal focus,” she said. “And for many members (of Congress) that voted for the ACA, it was just as important if not more so than the coverage side. The goal was to create a system that rewards better outcomes, better health and lower costs.”

Fowler said the COVID-19 pandemic has revealed some of the healthcare system’s shortcomings such as racial and ethnic disparities. It also exposed how fee-for-service breaks down as patient volumes drop precipitously.

Much of the healthcare system is “ready, willing, and able” to make the shift to value-based care, she said, but CMMI wants the alternative care models offered to position he participants for success.

“Sometimes that means speeding up when there's an opportunity, and sometimes it means taking a beat to ensure that a forthcoming model can realistically deliver on what's intended; that it's the strongest option based on our evidence and data,” she said.

This has led to some models recently being put on hold and others having delayed start dates. Fowler says that these actions are part of the center being agile and reacting to what works and what doesn’t.

In the 10 years since the center was established, Fowler said there has been a loss of consensus among the stakeholders about what it is trying to achieve and where it is going.

“I think it's in the time I have at CMMI I want to take a look at these questions and think about the bigger picture issue and focus on longer term health system goals,” she said.