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April 15, 2022

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  CMS Releases Strategic Plan Cross-Cutting Initiatives Aimed at Expanding Coverage, Improving Outcomes, and More
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CMS Releases Strategic Plan Cross-Cutting Initiatives Aimed at Expanding Coverage, Improving Outcomes, and More

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.”

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