Turns out that within the bill is the key to transforming American medicine, if only we use it for the powers of good. The Center for Medicare and Medicaid Innovation was established to” test innovative payment and service delivery models to reduce program expenditures under the applicable titles while preserving or enhancing the quality of care furnished to individuals under such titles. In selecting such models, the Secretary shall give preference to models that also improve the coordination, quality, and efficiency of health care services furnished to applicable individuals defined in paragraph (4)(A).” In English, to allow innovators to innovate, leading rapidly to better care. As someone who believes that there is a place for government in health care delivery, especially for those who rely on the government, either because of age or disparity, to provide access to quality healthcare. Don Berwick will be all over this. This program is seen as a¬†potential game changer for the following reasons:

  • Because it is set up to run “pilots” instead of “demonstrations” the approval of Congress isn’t necessary for every project and rapid replication is possible for successful pilots
  • 18 possible programs were offered as a choice rather than Congress dictating care based on their collective (or individual) whim
  • Budget neutrality is not required, meaning that you don’t have to predict outcome (or be afraid to attempt it) prior to starting a program
  • Funding ($10,000,000,000) is adequate to try several things at once

Mnay of these ideas have been through small pilot efforts already so it may be that transformation will be on a fast track. The list of projects include: