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CMS Seeks to 'Rapidly Reduce' Medicare Spending with $1B in Grants

John Commins, for HealthLeaders Media, May 17, 2013

"Without characterizing the first round of grants, maybe one might call it more generalized and aspirational. The second round is more results-oriented in asking for models that rapidly reduced spending and improve care for populations with special needs," he says. "So already they aren't just saying population health. They are saying population health with an emphasis on patients with special needs."

"This gets more specific when you look at the models they are looking for," says Roskey, a former health policy advice and counsel to the U.S. Senate Finance Committee. "They want approaches that test specific types of providers to transform their clinical and financial models. CMS is moving in Round 2 towards a grant environment that is going to force participants to show scalable provable propositions that can work in an environment where specificity is the rule and generality is the exception."

Roskey says oncology services for special needs populations is expected to be a focus of the grants as well. "For instance, oncologists or the clinical oncology delivery system in the community, or the academic medical center, or elsewhere maybe we take care of patients with specialized needs," he says.

"Not only do they have some type of cancer, they have other co-morbid conditions. While the Innovation Center has taken on accountable care and post-acute care and the notion of bundling payments, they have not yet taken fully on some of the various manifestations of cancer care."

CMS is also expected to target providers who serve populations with significant health needs, Roskey says.

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