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More than $350 million is up for grabs for health care organizations aiming to create innovative care models that provide better care for less money, and in early July, the Department of Health and Human Services announced the latest round of prospective recipients.
They included several hospitals with ideas that make transitions seamless, unplanned readmissions needless, or care in remote areas more accessible. Awards range from $2 million to $24 million and will be distributed over three years. Final notices for awardees will be sent later this year. (For more details on the project, visit http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.html.)
The prospective awardee programs include the following:
• Boston Medical Center — $6.1 million. The project "will test a Collaborative Care Coordination and Consultative Model for Complex Kids" that "pairs Complex Care Nurse Care Coordinators and Pediatricians...with pediatricians in the community to enhance and improve the care delivered to children with medical complexity in local medical home-like settings," according to CMS.
• Catholic Health Initiatives Iowa Corp., DBA Mercy Medical Center Des Moines — $10.2 million. Testing "a model to transition a network of rural critical access hospitals to value-based care through improved chronic disease management, increased clinical-community integration and lean’ process improvement initiatives," according to CMS.
• Detroit Medical Center, Vanguard Health Systems — $10 million. Testing a proposal "that would make primary care immediately available to individuals who arrive at 4 major inner city Emergency Departments for non-urgent care by establishing adjacent patient-centered medical home clinics. The initial focus will be on improving the care provided to patients with diabetes or asthma, and Emergency Department super-utilizers’ who have 10 or more visits annually. Medicaid fee-for-service beneficiaries will be the dominant target population. The program will expand to include patients with hypertension, congestive heart failure, chronic obstructive pulmonary disease, HIV, and depression. The design is based on the Nuka model in Alaska," according to CMS.
• Four Seasons Compassion for Life — $9.6 million. This North Carolina-based project, titled Increasing patient and system value with community-based palliative care, "will test a new model for community-based palliative care (in conjunction with Duke University), which spans inpatient and outpatient settings," according to CMS. "The model features interdisciplinary collaboration and the integration of palliative care into the health care system, continuity of care across transitions, and longitudinal, individualized support for patients and families. This expands upon a successful program in four Western North Carolina counties to include an additional ten counties."
• National Association Of Children’s Hospitals And Related Institutions — $23.2 million. Testing "Coordinating All Resources Effectively (CARE) for children with medical complexity (CMC), which aims to inform sustainable change in health care delivery through new payment models supporting improved care and reduced costs for CMC... This model aims to improve care and reduce overall health care expenditures for CMC by 1) creating a medically appropriate tiered system of care so that CMC of varying needs are cared for in the most appropriate settings to meet patient and family needs while lowering costs, 2) designing a payment system that will both sustain these programs and provide sufficient flexibility so that services will meet patient and family needs and 3) creating a learning system so that programs and payers across the country serving this population can rapidly learn from each other to improve care and design and implement effective payment models," according to CMS.
• The Nebraska Medical Center — $10 million. Testing the Remote Interventions Improving Specialty Complex Care (RIISCC) model, which uses "remote patient monitoring for 90 days post-discharge with telehealth consultations for participants at one of two community health centers located within the target geographic areas," according to CMS.
• New York City Health And Hospitals Corporation — $17.9 million. Expanding a current pilot program, this ED care management model "utilizes a multi-disciplinary team that will comprehensively assess patients who present in the emergency department for an ambulatory-care sensitive condition (ACSC), create a care plan that would avoid an unnecessary hospitalization, and provide ongoing support after discharge, including medication management, education, and linkages with primary care providers. The program will operate in 6 hospitals," according to CMS.
• Regents Of The University Of Michigan — $6.4 million. The project "will implement the Michigan Surgical and Health Optimization Program (MSHOP), which focuses on real-time risk stratification and peri-operative optimization for patients undergoing abdominal surgery," according to CMS.
• Seattle Children’s Hospital — $5.5 million. Testing implementation of "Pediatric Partners in Care (PPIC), which aims to provide a tiered set of community-based care management services to participating children, their families, and their primary care providers," according to CMS.
• University Of New Mexico Health Science Center — $15.1 million. Expanding the "existing telehealth infrastructure (11 hospitals) to form a statewide 30 hospital telehealth system (THS). In conjunction with Net Medical Xpress Solutions, the model test will provide remote emergency neurological consultation using inexpensive audiovisual equipment and software," according to CMS.
A full list of the Health Care Innovation Award round two project profiles is included in this PDF: http://innovation.cms.gov/Files/x/HCIATwoPrjProCombined.pdf