The Accountable Care Act is loaded with changes, many of them less than positive for Medicare home health providers. But one area of funding that could provide fertile ground for those who are forward thinking is the Centers for Medicare and Medicaid Innovation (CMI). The Center is starting with $5million in startup costs for 2010 to design, implement and evaluate models. It will then distribute $10 billion for pilot programs started between 2011 and 2019. Consider that $40 billion is coming out of Medicare home health over those ten years and you can understand why innovation is often ‘disruptive’. But today those models also have to be ‘evidence based’, proven through research.
The advent of a multitude of new models of care all seem to be connected in some way to home health as we have known it. Those include chronic care management, ReEngineering Discharge (RED), Better Outcomes for Older Adults Through Safe Transitions (BOOST), Transition Coaching, Independence at Home, the Patient Centered Medical Home and more. These new models, and others to come, meet the definition of ‘disruptive innovation’, a term coined by Clayton Christensen of Harvard. Innovation is ‘disruptive’ when it disrupts the existing revenue streams and existing relationships. If you want to get a head start on the pack, find a copy of Clayton Christensen’s The Innovator’s Prescription: A Disruptive Solution for Health Care. While the entire book is worth reading, chapter 5 is entitled “Disruptive Solutions for the Care of Chronic Disease.” Care at home is evolving rapidly.
You can read more about the Centers for Medicare and Medicaid Innovation at the Commonwealth Fund website, at the health policy site for the New England Journal of Medicine. Or if you want to perhaps offer expertise in starting up the new Center read the RFP from HHS at FedBizOpps.Gov. Take care.
