CMS cutting four Medicare payment models
CMS projects $750 million in savings from ending the four models early, but stopped short of saying where the savings would occur.
Photo: Walter Bibikow/Getty Images
The Center for Medicare and Medicaid Innovation (CMMI) is planning on ending four payment models by the end of the year in a bid to achieve a projected $750 million in savings, though the agency did not say where the savings would take place.
CMMI said it conducted a "comprehensive and data-driven review" based on the "clear statutory mandate given to the Center by Congress." Four models will end early, by Dec. 31, with the Centers for Medicare and Medicaid Services tasked with minimizing the disruption to patients in these models.
WHAT'S THE IMPACT
The models slated for termination are Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices and Making Care Primary.
CMS is also considering options to reduce the size of the Integrated Care for Kids awards or make other changes to the model, the agency said.
Further, the CMS Innovation Center will no longer pursue two previously announced models, the Medicare $2 Drug List and Accelerating Clinical Evidence.
The CMS Innovation Center said it determined its other active models can meet the statutory mandate – either as-is or with future modification – and will continue.
CMMI said it planned to announce a new strategy centered around preventing disease through evidence-based practices, saying it wants to drive choice and competition by empowering people with information to "make better choices."
The goal is to streamline CMMI's models, the administration said.
THE LARGER TREND
The announcement from CMMI is the latest in the Trump administration's efforts to find savings by slashing government funding and programs.
House Republicans' previously proposed budget looked at $880 billion in spending cuts from programs overseen by the House Committee on Energy and Commerce, which oversees Medicare, Medicaid and the Children's Health Insurance Program. If Republicans want to move forward with the cuts, it can't be done without slashing Medicaid, according to CBO projections.
The administration has also attempted to halt federal support for diversity, equity and inclusion (DEI) programs, although a federal judge in Maryland temporarily barred the order, saying it likely violates the First Amendment.
At the same time, President Donald Trump has been calling for the termination of several government positions, including at least 5,200 probationary employees at the Department of Health and Human Services.
The Trump administration cut about 1,300 employees, or 10% of the workforce, at the Centers for Disease Control and Prevention in February, according to NPR. As many as 1,500 employees at the National Institutes of Health were laid off.
Last month CMS announced that funds for the Affordable Care Act Navigator Program would be slashed from $98 million in 2024 to $10 million. This means that the pay for people performing the function of helping consumers choose an ACA plan is being cut, as is likely their navigator jobs. Funding for the navigator program was also slashed under the first Trump administration.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
