Two stocking-stuffers for people who track Medicare policy.
First, Center for Medicare and Medicaid Innovation releases its 75-page annual report to Congress. Recall that CMMI is a creation of the Affordable Care Act 2010, and has what reads like unlimited abilities to alter any Medicare regulation or law for the purpose of a demonstration project. Both democratic and republican administrations have tried big things under that clause, such as altering national Part B drug payment policy.
https://www.cms.gov/priorities/innovation/data-and-reports/2024/rtc-2024
Because of its breadth, I've always wondered if the Supreme Court would strike its authority down as being an unwarranted or open-ended delegation of authority from Congress to an agency. But I've not seen that argued.
Second, in Health Affairs, see an article by Cruse et al. on trends in Medicare Advantage supplemental benefits.
AI Corner
Chat GPT summarizes, concisely, the two articles.
CMS Innovation Center 2024 Report to Congress
The CMS Innovation Center's 2024 Report highlights its progress in testing payment and care delivery models to improve outcomes and reduce costs. Key strategies include advancing health equity, supporting safety net providers, and enhancing value-based care. New models like GUIDE for dementia care and AHEAD for state-based health equity reflect this focus. Evaluations emphasize scaling successful models, addressing health-related social needs (HRSNs), and fostering system transformation through multi-payer alignment and evidence-based innovation.
Medicare Advantage Supplemental Benefits
Medicare Advantage Organizations (MAOs) are shifting toward flexible nonmedical benefits addressing health-related social needs (HRSNs) like food, housing, and transportation, often via flex cards. While LTSS-like benefits (e.g., in-home care) are declining, VBID and SSBCI models increasingly target chronically ill and low-income beneficiaries. Challenges include flex card administration, potential impacts on eligibility for public programs, and beneficiary access in rural areas. Policymakers must consider beneficiaries’ experiences when shaping future MA policies.
Does the CMMI report contain any clues it was written by an outgoing Biden administration and that the next year's management will be under DJT?
The 2024 CMS Innovation Center Report to Congress does not contain overt signals that it was written by members of an outgoing Biden administration anticipating a Trump administration takeover. Instead, the tone remains forward-looking and nonpartisan, consistent with prior Innovation Center reports.
The report focuses on long-term goals, like achieving value-based care by 2030 and improving health equity, and highlights new models and bipartisan-supported strategies (e.g., addressing health-related social needs).
While it mentions significant progress during the current reporting period, there are no specific acknowledgments of a possible change in leadership, which is typical for federal agency reports during election cycles. If subtle signals exist, they might lie in:
- Future model risks: Mentioning VBID's demonstration status and spillover effects, which could imply awareness of policy vulnerability under different administrations.
- Neutral tone: A lack of partisan framing or overt alignment with administration-specific priorities.
However, such references are standard for federal reports and do not strongly indicate political foresight. If present, the signals are subtle and indirect, reflecting a cautious focus on continuity and evidence-based health reforms
