Last year, CMS Administrator
Chiquita Brooks-LaSure announced in a blog post that the agency would craft a “strategic plan” focused on improving
health equity, expanding coverage and improving health outcomes. This week, CMS
released a list of “cross-cutting initiatives” (CCIs) to carry out the strategic plan.
The goal of the
initiatives is to improve behavioral and maternal health coverage, drug price
affordability and rural healthcare delivery, along with strengthening quality-improvement
strategies and ensuring coverage for eligible individuals post-pandemic. The
CCIs will also identify opportunities to streamline the consumer experience of
CMS coverage programs and expand coverage, while leveraging data to drive
innovation and person-centered care. The CCIs touch on other topics as well, including
coverage-transition periods (such as the “Medicaid unwinding” expected to occur
at the end of the public health emergency), long-term care and benefit
expansion.
Below is CMS’
outline of the CCIs and how they relate to the agency’s strategic plan:
Elevating Stakeholder
Voices through Active Engagement
“CMS will ensure
that the public – particularly those most impacted and underserved – has a
strong voice throughout CMS’ policymaking, operations and implementation
process. By elevating voices and understanding the needs of individuals with
lived experience, their representatives, consumer advocates, providers, state,
local and tribal governments and health plans, CMS will have a more informed
process for decision making and understanding of how applied policies can
improve the lives of people. CMS is taking a meaningful approach in stakeholder
engagement through traditional outreach, agency-wide coordination, and by
meeting people where they are, in person, in communities, and in their
backyards.”
Behavioral Health
“CMS will embark on
a multi-faceted approach to increase and enhance access to equitable and high-quality
behavioral health services and improve outcomes for people with behavioral
healthcare needs. The CMS Behavioral Health Strategy will cover multiple
elements, including access to prevention and treatment services for substance
use disorders, mental health services, crisis intervention and pain care. It
further enables care that is well-coordinated and effectively integrated.”
Drug Price Affordability
“CMS will work
across programs to ensure that prescription drugs are accessible and affordable
for consumers, providers, plans, our programs and state partners. This work
will include: using data and information to drive transparency and improve
decision making; leveraging our tools to reward innovation and ensure access to
drugs that improve health outcomes; and improving affordability by increasing
the use of generics, biosimilars and interchangeable biologics, as well as
reducing ineffective spending in Medicare and Medicaid by encouraging provider
and plan accountability for outcomes and equity.”
Maternity Care
“CMS will develop
and implement a coordinated maternity care strategy, seizing every opportunity
to improve maternity care access and quality, improve health outcomes and
reduce disparities. CMS will work with states, healthcare facilities, community
providers and other partners to improve the quality of maternity care, expand
postpartum coverage and support a diverse provider workforce. These efforts
will reward high-quality care, expand access to coverage and care, and begin to
address the health inequities that underlie our healthcare system.”
Benefit Expansion
“CMS will cohesively
implement policy changes and consider opportunities to expand access to
coverage and benefits, including dental coverage and underused high-value
services, using existing authorities and health plan flexibilities. Access to
services that promote health and wellness is critical to allow beneficiaries
and consumers to achieve the best health possible, consistent with current
program design for Medicare, Medicaid/CHIP and the Marketplace. CMS plans to
engage in partnership with states, health plans and healthcare providers to
find opportunities to expand coverage, improve access for underused benefits,
and consider opportunities to use our authorities creatively to expand access
to care.”
Rural Health
“CMS will work
across programs to promote access to high-quality, equitable care for all
people served by our programs in rural and frontier communities, tribal
nations, and the U.S. territories. By engaging with our stakeholders, including
providers, quality-improvement organizations and those with lived experience,
CMS will ensure our approach is responsive to their unique needs. CMS will
build on previous efforts in consultation with the Rural Health Council to
improve rural healthcare delivery, developing a comprehensive, cross-center
strategy to advance health equity, expand access and improve health outcomes.”
Preparing the
Healthcare System for the Post-Pandemic World
“CMS will continue
to work collaboratively to prepare the healthcare system for operations after
the public health emergency. This will include releasing and/or updating
regulatory and sub-regulatory guidance, technological improvements, technical
assistance to states, and public education of the necessary steps to successfully
prepare for and operate after the public health emergency. CMS will continue
evaluating lessons learned during the public health emergency to restore the
minimum health and safety standards needed to improve quality across the
continuum of care.”
Coverage
Transition
“CMS will ensure as
many individuals enrolled in Medicaid and the Children’s Health Insurance
Program (CHIP) maintain a source of coverage as possible after the COVID-19
Public Health Emergency continuous enrollment requirement expires, whether
through Medicaid/CHIP, Marketplace, employer coverage or Medicare. The
continuous-enrollment requirement prevented states from terminating most
Medicaid beneficiaries during the pandemic, ensuring enrollees had access to
healthcare during a public health crisis, but all individuals will need a
redetermination of eligibility when the PHE ends. This will be accomplished by
providing state Medicaid agencies, Marketplaces and their partners with clear
policy guidance and tools, technical assistance, and a strong outreach and
communications strategy.”
National Quality
Strategy
“CMS will shape a
resilient, high-value healthcare system to promote quality outcomes, safety,
equity and accessibility for all individuals, especially for people within
historically underserved and under resourced communities. Opportunities
continue to exist to improve quality for all individuals within the healthcare
system, especially following the COVID-19 Public Health Emergency. The CMS
National Quality Strategy takes a person-centric approach to quality and safety
and seeks to improve the overall care journey as individuals move across the
continuum of care, from home or community-based settings to hospitals and
post-acute care. This initiative accounts for all individuals and entities that
are vital to optimizing a person-centered approach to care.”
Nursing Homes and
Choice in Long-Term Care
“This effort will
focus on: having every nursing home employ a sufficient number of staff who are
adequately trained to deliver high-quality care; holding poorly performing
nursing homes accountable for unsafe or improper care; and providing better
information to the public on nursing home quality and ownership transparency.
CMS is equally committed to expanding access to care for home- and
community-based services and will continue efforts to ensure people receive
high-quality long-term services and supports in the appropriate setting of
their choice.”
Data to Drive
Decision-Making
“CMS will accelerate
the appropriate use of data to deliver on our mission and serve the public
while protecting security and privacy. This initiative will allow CMS to make
more informed policy decisions based on data and drive innovation and
person-centered care through the seamless exchange of data. CMS is working to
fully leverage the value of data by improving our data collection and
management, advancing our analytic capabilities, and promoting data
transparency and dissemination.” |