Reflecting on 10 Years of Healthcare Innovation

The Econometrica Team celebrates the 10-year anniversary of the Affordable Care Act and the many innovations it created.

Bethesda, MD, March 2020

On March 23, the Patient Protection and Affordable Care Act (ACA) celebrates its 10-year anniversary. A landmark body of legislation, the ACA has left a lasting impact on healthcare in the United States. One of the key tenets of the legislation highlights its dedication to original and novel solutions to healthcare challenges: the creation of the Center for Medicare and Medicaid Innovation (CMMI), also known as the Innovation Center within the Centers for Medicare & Medicaid Services (CMS). In the past decade, the Econometrica Team has engaged with several CMMI programs designed to improve quality of care while reducing costs. We mark this milestone by reflecting on the past 10 years of work in this space and looking forward to future innovations.

Since its inception through CMMI, Econometrica has been influential in the success of the Hospital Innovation and Improvement Network initiative, formerly known as the Partnership for Patients initiative. This initiative seeks to improve healthcare safety and quality by reducing harm in hospitals and reducing readmissions through public–private partnerships. In the first iteration of the initiative, Econometrica served as the National Content Developer. In this role, Econometrica supported Hospital Engagement Networks in identifying, sharing, and celebrating innovations in care redesign that improved patient outcomes and reduced readmissions in key areas (e.g., adverse drug events, early elective deliveries). Econometrica served as the evaluator for the initiative and investigated the savings and improved patient outcomes for the first and second iteration of the model. We have supported the third iteration of the model through our work monitoring Patient and Family Engagement activities and providing evidence-based resources on how to expand the innovation.

Econometrica supported CMS on the Medicaid Incentives for Prevention of Chronic Diseases program by monitoring the program’s effectiveness and providing technical support to participants. The demonstration program tested the effectiveness of offering incentives to Medicaid beneficiaries who took part in prevention programs to address one of the following health behaviors or outcomes: curbing tobacco use, controlling or losing weight, lowering cholesterol or blood pressure, and avoiding the onset of diabetes or improving diabetes management. Econometrica supported the 10 States that received grants in implementing the program, created and put into action a learning system, collected performance data, and organized meetings for grantees.

Another of Econometrica’s early CMMI initiative-related evaluation projects was the Evaluation and Monitoring of the Bundled Payments for Care Improvement Model 1 Initiative, which connected payments for services provided to beneficiaries during an episode of care. Econometrica evaluated changes in service utilization patterns, patient case mix, incidence of harm, quality of care, changes in key health outcomes of patients, and Medicare expenditures, and collected primary qualitative data by interviewing participants. We designed and administered a Patient Health and Experience Survey to certain beneficiaries to understand their care experience. We are currently building on this work under our Learning System for Bundled Payments for Care Improvement Advanced Model contract, in which we are researching and recommending which quality measures to use to evaluate participant performance in the model, responding to help desk tickets, and assisting with a data feedback dashboard that monitors model performance.

Our other current work on CMMI initiatives includes engagements with the Million Hearts® and Comprehensive Primary Care Plus (CPC+) models. Million Hearts® aims to reduce the risk of cardiovascular disease and improve outcomes for people at risk of heart attacks and stroke. Econometrica assists with the program implementation by validating beneficiary eligibility for the program, tracking provider use, and creating payment files for claims processing for each beneficiary.

Our work on CPC+ falls into two projects that support the model, which seeks to improve primary care through regional transformations of care delivery and multi-payer reform. Econometrica produces a series of data extracts consisting of claims and administrative data, which are sent to more than 300 individual practices participating in CPC+. We also aggregate data extracts that are provided to four regional aggregators participating in CPC+.

We look forward to continuing to support CMS’ dedication to innovative models that promote the delivery of high-quality healthcare at reduced cost. Happy birthday, CMMI!