On July 14 the Centers for Medicare & Medicaid Services (CMS) announced the Medicaid Innovation Accelerator Program (IAP), an initiative to provide $100 million in federal funding for technical assistance (TA) to states to accelerate Medicaid delivery system reform across the country. The TA will support states in their efforts to pursue the triple aim of better care, better health, and lower costs for Medicaid beneficiaries. While details of how the TA will be provided continue to evolve, the IAP announcement is a strong signal that CMS is increasing its focus on Medicaid delivery system reform. Notably, the National Governors Association (NGA) is simultaneously launching an initiative aimed at statewide Medicaid transformation, highlighting that HHS and states share a strong interest in finding ways to work together on delivery system reform.
HHS’s IAP Initiative
The IAP is a collaboration between the Center for Medicaid and CHIP Services (CMCS) and the Center for Medicare & Medicaid Innovation (CMMI), working closely with the Medicare-Medicaid Coordination Office, the Center for Medicare, and other federal centers and agencies. The IAP will finance $100 million of technical assistance in four primary areas, as well as create a “one-stop shop” for states looking for answers from HHS on Medicaid and delivery system reform. The IAP does not provide any new grant funding for states, although it could help states to find new ways to take advantage of existing funding streams (e.g., Medicaid 1115 waivers or State Innovation Model (SIM) grants).
The IAP will focus on developing TA resources in four primary areas:
Identification and Advancement of New Models. The IAP will develop tools to help implement promising models of care. Using input from states and other stakeholders, CMS will target areas of high need (e.g., high spending, high disease burden, and/or high disparities), explore interventions that show evidence of improved care and/or reduced costs, and seek to complement existing efforts.
Data Analytics. The IAP will help states leverage existing data, including T-MSIS, Medicaid and CHIP performance data, and data from other sources, to identify best practices and interventions.
Improved Quality Measurement. The IAP will align and integrate health quality measures across Medicaid-related healthcare programs and initiatives.
State-to-State Learning, Rapid-Cycle Improvement, and Federal Evaluation. The IAP will disseminate information about best practices being adopted in the states, support state rapid-cycle improvement efforts, and align and coordinate federal evaluation of Medicaid transformation efforts.
NGA Policy Academy
In coordination with HHS, the NGA has launched a new Policy Academy titled “Leveraging Medicaid to Create Statewide Healthcare Transformation.” The goal of the Academy is to help secure an “agreement in concept” between each of the participating states and the federal government on an approach to Medicaid delivery system reform. The Academy is open to three to five states that will be selected through a competitive application process, but it also aims to develop tools that can be used by all states to more quickly and easily secure HHS approval of promising statewide Medicaid transformation initiatives. HHS has agreed to work closely with NGA on the initiative, suggesting that the Policy Academy could become an important source of ideas and information for the federal agency.
Everyone interested in Medicaid and delivery system reform will want to watch the IAP and NGA Policy Academy closely in the weeks and months ahead. It is clear that HHS is giving new attention and resources to Medicaid delivery system reform, and that there will be important opportunities and developments in the months ahead out of both HHS and NGA.
CMS will hold webinars and meetings over the next couple of months to solicit input on the IAP from states, consumer groups, providers, health plans, and subject matter experts. States that are interested in the IAP can find information here. They also can email MedicaidIAP@cms.hhs.gov, contact their Medicaid State Operations and Technical Assistance (SOTA) lead, or other CMS staff with whom they work. In the future, CMS plans to provide one IAP point of contact for states.
States that are interested in applying to the NGA Policy Academy must submit an application by August 22, 2014. A copy of the application is available here.