Comments on: Medicare’s Biggest Change in 40 Years on the Horizon? http://e-CareManagement.com/medicares-biggest-change-in-40-years-on-the-horizon/ Chronic Disease Management • Technology • Strategy • Issues and Trends Wed, 10 Mar 2010 19:15:42 -0700 http://wordpress.org/?v=2.8.2 hourly 1 By: Randy Williams http://e-CareManagement.com/medicares-biggest-change-in-40-years-on-the-horizon/comment-page-1/#comment-12294 Randy Williams Fri, 30 Oct 2009 13:13:47 +0000 http://e-CareManagement.com/?p=1270#comment-12294 The analysis offered is helpful and suggests that CMS is transitioning from a large "one size fits all" payer to a regional innovation "participant". An alternative analysis is that CMS is trying too many things at once, and that without a strong internal champion at CMS, Secretary Sebelius has concluded that "less is more". In other words, that CMS should leverage existing state innovation structures and efforts where they exist. I don't think this should be over read as a global shift, however. There is a strong personal relationship between the Secretary and the Vermont governor, who's state is one likely to be awarded CMS participation in their Medical Home initiative. Also, CMS is likely to become the recipient of $10 Billion in new funding to form the CMS Innovation Center. What federal employee would want to just give that money away! There will continue to be CMS only innovations; the medical home may not be one of them. But, there are others that may not best be done by regional consortiums. So, my conclusion is that there was general healthy skepticism of the MMHD from many on the Hill and in the Administration (they probably are all regular readers of this Blog!) and that this was an "easy out". The analysis offered is helpful and suggests that CMS is transitioning from a large “one size fits all” payer to a regional innovation “participant”. An alternative analysis is that CMS is trying too many things at once, and that without a strong internal champion at CMS, Secretary Sebelius has concluded that “less is more”. In other words, that CMS should leverage existing state innovation structures and efforts where they exist.

I don’t think this should be over read as a global shift, however. There is a strong personal relationship between the Secretary and the Vermont governor, who’s state is one likely to be awarded CMS participation in their Medical Home initiative. Also, CMS is likely to become the recipient of $10 Billion in new funding to form the CMS Innovation Center. What federal employee would want to just give that money away! There will continue to be CMS only innovations; the medical home may not be one of them. But, there are others that may not best be done by regional consortiums.

So, my conclusion is that there was general healthy skepticism of the MMHD from many on the Hill and in the Administration (they probably are all regular readers of this Blog!) and that this was an “easy out”.

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