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The Centers for Medicare and Medicaid Services (CMS) announced the first round of recipients of the Health Care Innovation Awards on May 8.

The Health Care Innovation Challenge, launched last November, was designed to generate creative approaches to health care delivery that improve health, enhance health care, and lower costs for individuals enrolled in Medicare, Medicaid, and CHIP.

The 26 awarded projects total $122.6 million, approximately 10 percent of the $1 billion in grant funding to be administered through the Centers for Medicare and Medicaid Innovation (CMMI).

The recipient programs span a wide range of topics, including interventions to:

• improve chronic disease management for underserved populations,
• enhance primary care outcomes through the use of community health workers,
• reduce emergency care admissions, and
• lower re-hospitalization rates.

The 26 awardees were selected based on their unique approaches to addressing health care challenges, as well as their integration of workforce development and cost savings benefits for local communities.

In a call with stakeholders the day that the grants were announced, CMMI Director Richard J. Gilfillan said that the next round of awards will be announced in early June. Gilfillan would not confirm whether the second round would feature a similar number of awardees, or whether there will be a third round of funding.

The awards were originally scheduled to be announced in March, but CMS delayed the announcement in order to more thoroughly consider the 3,000-plus applications submitted at the start of the year.

– by Angelina Del Rio Drake, PHI Development Writer

The Centers for Medicare & Medicaid Services (CMS) released final regulations (pdf) for the Community First Choice (CFC) Option after incorporating input from stakeholders, including PHI (pdf).

The CFC Option is a new state plan option in the Medicaid program created by the Affordable Care Act.

States that participate in the CFC Option will receive a six percentage point increase in federal Medicaid matching funds (FMAP) to provide home and community-based services (HCBS) to beneficiaries who would otherwise receive services in an institution.

As noted in a recent Kaiser Family Foundation report, many states continue to face high demand for Medicaid services while state resources are limited.

Some states have implemented — or are considering — a wide range of Medicaid cost-containment measures, including significant cuts in eligibility and benefits for some groups.

Opportunity to Improve Direct-Care Jobs

Not only does the CFC Option offer states additional funding for expanding Medicaid HCBS, it is also an opportunity to improve direct-care jobs, explains a PHI health reform fact sheet (pdf).

“This is an important opportunity for states to achieve their rebalancing goals and invest in a strong personal care attendant (PCA) workforce,” said Carol Regan, PHI government affairs director.

“We urge advocates to promote participation in the CFC Option in their states and to encourage state policymakers to use of some of the new federal funds to improve compensation for PCAs, while expanding services,” Regan said.

Although the CFC Option regulations are final, CMS is seeking additional public comments on how “home and community-based settings” should be defined. That definition will apply to the CFC Option as well as to other Medicaid programs that deliver HCBS.

On an April 27 call with stakeholders, CMS representatives encouraged interested states to proceed with the CFC Option implementation while the definition of “home and community-based settings” is being finalized.

For states deciding to begin implementing the CFC Option, CMS will provide “at least one year” of transition time to allow them to adjust once the final rule defining HCBS settings is published.

– by Gail MacInnes, PHI National Policy Analyst

The Centers for Medicare and Medicaid Services (CMS) Innovation Center has delayed the determination of the Health Care Innovation Challenge awards by “several weeks.”

The CMS agency had originally set March 30 as the award date. However, due to the large number of proposals received — about 3,000 — more time is needed to process applications under review, according to a March 26 update on the agency website.

Regarding a second round of funding, the Innovation Center site says that no determinations will be made “until the first round of awardees have been announced.”

– by Deane Beebe

In an article published in the January-February 2012 issue of AgingToday, a publication of the American Society on Aging, PHI proposes developing an “advanced aide” position that could play a critical role on care teams to improve outcomes and cost efficiencies.

“Making the Most of Direct-Care Workers with a New Role on the Care Team” (pdf) explains that with delivery system reforms moving toward managed care and the Affordable Care Act‘s emphasis on testing new coordinated care models, this is an ideal moment to “engage in a thoughtful redesign of the role of the direct-care worker.”

One of the specific opportunities the authors mention is the recent request for proposals for the Center for Medicaid and Medicare Innovation “Health Care Innovation Challenge” grant.

Well Worth the Investment

The creation of an advanced aide position “would be well worth a substantial investment in training, support and compensation,” write the authors, PHI Policy Analysts Gail MacInnes and Meghan Shineman.

“Advanced aides could support health promotion, improved chronic care management and better care transitions — resulting in less institutionalization, fewer re-hospitalizations, and decreased emergency room visits.”

Employers could determine how advanced aides “could play a stronger role in a more integrated care team,” suggest the authors, who add that it is “too early to articulate a precise portable definition” of the Advanced Aide position but the time is ripe for experimentation.

Enhancing the role of direct-care workers is the intent of a bill recently introduced by Senator Robert Casey (D-PA) to establish demonstration projects that focus on care coordination and service delivery redesign for older adults with chronic illnesses, or those at risk of institutional placement.

– by Deane Beebe

The Centers for Medicaid and Medicare Services (CMS) and Administration on Aging (AoA) have been hosting webinars on applying for the new federal Health Care Innovation Challenge grant.

The webinar will be held on Thursday, Dec. 8 at 1 p.m. EST.

To view the webinar, register online.

Visit the CMS Innovation Center’s Events Archive to view a recording of the first webinar — an overview of the grant — and check back for the other webinars.

PHI recently published its own online guide to developing a strong Innovation Grant proposal.

The Health Care Innovation Challenge, which will provide up to $1 billion in grants from the Center for Medicare and Medicaid Innovation to “test creative ways to deliver high-quality health care services and lower costs,” was launched by the Department of Health and Human Services (HHS) on November 14.

“The Innovation Challenge is an exciting opportunity to design creative care models that expand the role of direct-care workers in an array of long-term care settings,” said Steve Edelstein, PHI national policy director. “It also signals the importance of HHS’s commitment to models that integrate these frontline workers into the care team to improve the care outcomes for elders and people living with disabilities.”

Grants ranging from approximately $1 million to $30 million for a three-year period will be awarded to applicants proposing the most compelling new ideas to deliver better health, improve care, and lower costs for people enrolled in Medicare, Medicaid, and CHIP — particularly those with the highest health care needs.

New Models of Workforce Development and Deployment

The Innovation Center will give preference to proposals that include “development and/or deployment of health care workers in new, innovative ways.” For example:

• new roles and skills for an existing workforce,
• new types of workers to support core transformation of the health care delivery system, and
• team-based models as better methods to serve a particular population.

Successful proposals, according to the grant guidelines, must include an innovative, explicit workforce development plan, one that requires new roles for all staff engaged in the new models of care and new skills to manage team building and care coordination.

“Training and educational experiences will be needed” to develop the skills required for the “health care workforce of the future,” states the announcement, which also notes that “preference will be given to projects that implement their care improvement activities faster than six months.”

The Innovation Center was created under the Affordable Care Act as part of the Centers for Medicare and Medicaid Services (CMS).

More information on the Health Care Innovation Challenge is available on the CMS website.

Important Health Care Innovation Challenge Dates

• Letter of intent: due December 19, 2011
• Applications: due January 27, 2012
• Awards Granted: March 2012

– Originally published at PHInational.org by Deane Beebe