Section 646 of the Medicare Modernization Act (MMA) mandated a 5-year demonstration program under which the Centers for Medicare & Medicaid Services (CMS) would test major changes to improve quality of care while increasing efficiency across an entire health care system.
Background
CMS intended to use this demonstration to identify, develop, test, and disseminate major and multi-faceted improvements to the health care system. Broadly stated, the goals of the Medicare Health Care Quality demonstration were to:
- Improve patient safety;
- Enhance quality;
- Increase efficiency; and
- Reduce scientific uncertainty and the unwarranted variation in medical practice that results in both lower quality and higher costs.
Initiative Details
These projects involved the use of alternative payment systems for items and services provided to beneficiaries, and potentially involved modifications to the traditional Medicare benefit package. The provision included a budget neutrality requirement over the 5-year duration of the program. Physician groups, integrated delivery systems, and regional health care consortia were eligible to apply for the demonstration.
Results from the respective participants are listed below:
- Gundersen Lutheran Health System
- Indiana Health Information Exchange (IHIE)
- IHIE Fact Sheet (PDF)
- IHIE Performance Year One Results (PDF)
- IHIE Performance Year One Results Summary (PDF)
- IHIE Performance Year Two Results (PDF)
- IHIE Evaluation Year Two Report (PDF)
- IHIE Evaluation Case Study Report (PDF)
- IHIE Performance Year Three Results (PDF)
- IHIE Evaluation Year Three Report (PDF)
- Meridian Health System
- North Carolina-Community Care Network (NC-CCN)
- NC-CCN Fact Sheet (PDF)
- NCCCN Performance Year One Results (PDF)
- NC-CCN Revised Performance Year One Results (PDF)
- NC-CCN Performance Year Two Results (PDF)
- NC-CCN Evaluation Case Study Report (PDF)
- NC-CCN Evaluation Year Two Report (PDF)
- NC-CCN Performance Year Three Results (PDF)
- NC-CCN Evaluation Year Three Report (PDF)