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CONCLUSION
During the first phase of the Catalyzing Health Innovative Health Transformation initiative, the Center for Medicare & Medicaid Innovation (CMMI) was undertaking its strategic and operational planning process in alignment with the Biden–Harris administration’s health and health care agenda. In early 2021, the Biden–Harris administration highlighted areas including tackling the converging crises of the COVID-19 pandemic, advancing racial equity, and expanding access to quality affordable health care (The White House, 2021). After completing the first phase of this project, CMMI’s culminating Innovation Center Strategy Refresh cited the National Academy of Medicine Expert Panel Review as a validating factor in moving CMMI toward re-examining its portfolio of efforts to accelerate health system transformation and the adoption of value-based care (CMMI, 2021). Throughout the second project phase, CMMI continued to provide active counsel and input on discussions to inform its strategy implementation efforts, particularly its efforts to evaluate the limits of their statute, signal upcoming developments on multi-payer alignment efforts, and refine the approach to collecting equity data in support of payment policy to account for the equity, cost, quality, and degree of systems transformation.
While the strategies, programs, and models presented in this publication outline discuss the gaps and solutions related to promoting value-based care and the need to collect and apply data to support equity, it does not place in stark terms the grave reality of the nation’s overall health and the state of the health care system. For example, the health system is not achieving the basic aims of care access, administrative efficiency, equity, and health care outcomes. Each is among the lowest compared to other
more economically developed countries (Tikkanen and Abrams, 2020). More concerningly are the outcomes of the nation’s current health and health care system. In 2020, U.S. life expectancy fell by one year, driven by the high mortality rate of Black and Latino/a populations during the COVID-19 pandemic (Andrasfay and Goldman, 2021).
Where federal efforts to build on the advancements of the Affordable Care Act have stalled, it is more critical that CMMI’s impact broadens to meet the challenges of today. CMMI has the potential to catalyze the use of science and policy and create the necessary innovation and advancements to transform the nation’s health and health care system. If it accomplishes this goal, it will have changed the paradigm of health and health care to include coordinating stakeholders toward adopting value-based care models and collecting data to support equity, embedding upstream drivers of health services and supports in its future programs, and creating the incentives and policies to finance and reward quality, value-based care. Paramount is that these efforts translate into tangible results that impact the lives, experiences, and health of the nation’s beneficiaries of health and health care.
