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News April 2012

Aid for Age

Innovative Health Care Programs Initiative Will Create New Jobs Quickly

By Tait Trussell

The stated aim is to find new ideas for care to people in Medicare, Medicaid and CHIP (the children’s health program). The new money will be handed out in grants to organizations and local governments that work with patients in those federal programs.

The White House is pouring $1billion into jobs for health workers. Seniors may benefit from more innovative care under Medicare and Medicaid.

On November 14, the Centers for Medicare and Medicaid (CMS) announced what it called a “funding opportunity” of up to $1 billion for “innovative projects across the country to deliver health care.” Importantly, “Priority will be given to projects” that hire people rapidly....”

The stated aim is to find new ideas for care to people in Medicare, Medicaid and CHIP (the children’s health program). The new money will be handed out in grants to organizations and local governments that work with patients in those federal programs.

Interestingly, the health care sector is one of the few areas where jobs already are growing. According to the Bureau of Labor Statistics (BLS) “Health Care employment continued to expand in October 2011 (+12,000), following a gain of 45,000 in September. Offices of physicians added 8,000 jobs in October. Over the past 12 months, health care has added 313,000 jobs.

Health care jobs are expected to grow by 3.2 million by the end of this decade, BLS said.

The Supreme Court has decided to hear arguments in March for and against the Affordable Care Act’s constitutionality. A decision may come before the 2012 election.

The Obama administration believes a much larger health workforce will be required to deal with the health care insurance program when it is scheduled to begin to encompass millions of Americans in 2014. At least 32 million people are expected to be covered by insurance in 2016, if the law is upheld by the Supreme Court.

The Association of American Medical Colleges estimates that in the next decade nearly one-third of current doctors will retire, and the country will face a shortage of more than 90,000 doctors. By 2025, the projected deficit of physicians will reach more than 130,000 in all specialties.

The country has a current population of 310 million. This number grows by 25 million every decade. Of the total, 37 million are 65 or older.

The Health Care Innovative Challenge, as it is called, will be a hustle-up program. Grants will be given as early as this coming March. Applicants had to have their letter of intent in by Dec. 19, with applications due by Jan. 27. “Applications will be open to providers, payers, local government, public-private partnerships, and multi-payer collaboratives,” the Centers for Medicare and Medicaid (CMS) “Innovation” project said. “The Health Care Innovative Challenge will encourage applicants to include new models...to support their service delivery model proposal. All proposals “must be operational or capable of rapid expansion within six months.”

Awardees “will provide regular updates” on their progress and data to CMS. “CMS will also collect from awardees a standard minimum set of performance indicators through its monitoring and coordinating contractors.”

In other words, CMS will hire more people “independent entities to assist in monitoring the programs...” That means more employees. “Awardees will also participate in learning sessions about how health care delivery organizations can achieve performance improvements quickly and effectively.”

The Innovative Center said it has received ideas from several Accountable Care Organizations. ACOs are modeled on integrated delivery systems such as the Mayo Clinic, Geisinger Health System, Kaiser Permanente, and Intermountain Healthcare. While ACOs can be designed with varying features, most models put primary care physicians at the core and emphasize simultaneously reducing costs and improving quality. The emphasis is on physicians rather than insurers or hospitals because physicians influence about 90% of all personal health decisions.

During the first two years, the candidate organizations will operate under a shared savings arrangement. If successful, payments will transition, as the DMCB understands it, to fee-for-service reimbursements.

Other insurers also have to join in and the number of their patients has to comprise more than 50% of the total. Much of the payment details are being left intentionally vague so that CMS can be flexible, the CMS announcement said.

In the application process, these ACOs will also need to document how they are prepared to meet the needs and preferences of their patients with "patient-centered care." Patients will be notified that they can call a 1-800 number with any concerns. The Innovations Center hopes 30 programs will eventually participate.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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