Democrats expect key CMS initiative to survive Supreme Court

By Brian Dolan
03:21 am

Brian Dolan, Editor, MobiHealthNewsWe first encountered plans for the Center for Medicare and Medicaid Innovation (CMMI) in early 2010, when many of the center's goals were laid out in a 25 page (mostly mobile) health-focused chapter of the FCC's National Broadband Plan. With the passing of the Affordable Care Act, Congress allocated $10 billion through the year 2019 to fund the creation of what was then called the CMS Innovation Center.

Dr. Mohit Kaushal, who in 2010 was leading the FCC's policy team on the healthcare front -- he's since joined the West Wireless Health Institute -- explained to the audience at the WLSA Convergence Summit in 2010 how the CMMI would be the single most important initiative for changing how payers reimburse for wireless health services.

Kaushal argued at the time that while CMS has traditionally been able to conduct pilots that tested out innovative payment models, it was hard for pilots to get implemented at "the macro level."

Learn on-demand, earn credit, find products and solutions. Get Started >>

With a Supreme Court ruling on the constitutionality of the Affordable Care Act's individual mandate expected in the coming weeks, it has been suggested that the court could strikedown the entire legislation.

During a panel session convened by the American Center for Progress, Senator Sheldon Whitehouse (D-RI) said that “the only part of the massive bill being challenged is the individual mandate. That’s the only aspect that, some say, the federal government can’t do, only the states, which is a very narrow question,” he said. “So if the mandate falls, there is some logic -- not great logic, but if you stretch, some logic -- to that. But there is no logic” to going after the pilot programs that CMS is pursuing, a report in Government Executive quoted him as saying.

Whitehouse also said that some 45 sections of the health care law gave CMS responsibilities to conduct pilot programs, according to reports.

The director of the CMMI, Richard Gilfillan also participated in the panel, which was called "Obamacare at Work: Innovations to Deliver Better Care at Lower Cost." As one example of the impact the CMMI has had, Gilfillan pointed to “the incredible response” that the CMMI received from private healthcare providers across the US to a CMS grant offer that sought models for interpreting data on cost savings from bundled payments, according to The New York Times. The CMMI received about 3,000 applications.

During his comments on the panel, Whitehouse predicted that the "delivery system reforms will survive, and we should not be stalling and dawdling because we are anxious about what the court will do."

Matt Wiggins, CEO of Remedy Systems, which works with a number of insurance companies to create mobile tools for healthcare providers, hopes the CMMI survives.

"The CMMI designed policies that led to the creation of new types of customers for mobile entrepreneurs looking to solve the real cost problems in healthcare," Wiggins told MobiHealthNews in an email. "By nurturing a market where modern technology -- like iPad applications -- can be used to coordinate care for ACOs and awardee conveners under Bundled Payments, the CMMI has made it exciting to work towards the construction of the future."

On a somewhat related note, the MobiHealthNews team is looking forward to the HHS's Health Data Initiative Forum III in Washington DC next week. The event is a public-private partnership that aims to enable the independent development of health applications through easier access to expanded, free data. See you there!


The latest news in digital health delivered daily to your inbox.

Thank you for subscribing!
Error! Something went wrong!