Will Republicans Keep CMMI After All?

With President-elect Trump and Republicans in Congress both elected on a platform of repealing Obamacare, the Center for Medicare and Medicaid Innovation (CMMI), which was created by the law, would seem to be a likely target for elimination.

Perhaps not. According to story in CQ-Roll Call, now that it is about to fall into their hands, CMMI may have some appeal.

Republicans, who are now in control of the White House and both chambers of Congress, could reshape the center to their own ends.

“I think done right, clearly, innovation is key to making health care affordable and saving Medicare for the long term. But that agency needs real scrutiny,” [Rep.] Brady said.

The center could be used by Republicans to pursue changes in Medicare and Medicaid that they might not be able to do legislatively. At the very least, Republicans want to see how they might make the innovation center more transparent and keep it from doing anything they wouldn’t approve.

According to a story in the National Law Review:

The ACA created CMMI to test innovative payment and service delivery models to reduce program expenditures and improve care.  To carry out this goal, the ACA allows CMMI to waive any Medicare provision of the Social Security Act, as well as select Medicaid provisions, that may be necessary to carry out and evaluate demonstration policies.  If the demonstrations prove effective, CMS may implement the program nationally.

Some congressional Republicans, including Rep. Tom Price (R-GA), who the president-elect has nominated to lead HHS, have opposed some of CMMI’s demonstrations, such as a change in how hip and knee replacements would be paid for.  But, according to National Law Review:

CMMI provides an avenue to test and garner buy-in for new models of care that otherwise did not exist.  Republicans may realize the opportunity that CMMI could provide as they transition away from the Affordable Care Act.  If Republicans want to maintain this authority or provide states greater authority to demonstrate coverage models, they could leverage CMMI’s authority to do so.

Update (1/24/17):  President Trump’s HHS nominee, Tom Price, told a Senate committee today that he may preserve CMMI, according to the Morning Consult.

Price told the Senate Finance Committee on Tuesday that innovation is important to medicine, and that the Center for Medicare and Medicaid Innovation “is a vehicle that might” support innovation. The CMMI was created under the Affordable Care Act to test new ways of delivering health care, with the goal of increasing quality and lowering costs.

“We can move CMMI in a direction that actually makes sense for patients,” Price said.


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