Letting a Hundred Flowers Blossom: HCIA Round Two Provides $1 Billion to Test New Models of Care













Jack Challis is the CEO and co-founder of CliniCast.

By virtually every measure, the United States’ healthcare system spends far too much for health outcomes that are sub-par in comparison to the rest of the developed world. Policy makers at the local, state and federal level agree that Americans should have better quality care and better health outcomes at significantly reduced prices, but very few agree on the specific changes that need to be made. Providers, health systems, government bodies, technologists and a host of others have put forward a multitude of proposals to reduce this systemic cost, which begs the question, which programs are worth implementing?

The Affordable Care Act addressed this issue by setting aside $10 billion over a 10-year period to fund Health Care Innovation Awards, grants specifically designed to test new models of delivering and paying for care. Each awardee receives between $1-30 million to prove out their model of delivering care over a three year period. The most successful programs could provide a template for deployment nationwide.

The first round of funding, announced last year, provided almost $900 million in funding for 107 programs. Several of these programs explicitly included technology for care coordination, telemedicine, medication reconciliation, decision support and shared decision making.  Information on the first group of awardees is available here: http://innovation.cms.gov/Files/x/HCIA-Project-Profiles.pdf

Now the Center for Medicare & Medicaid Services has announced Round Two of these awards, again funding roughly 100 programs with up to $1 billion in grants. The stated goals of this program include:

  • Reducing cost for Medicare, Medicaid and CHIP beneficiaries in outpatient and /or post-acute settings
  • Improving care for populations with specialized needs
  • Testing approaches for specific types of providers to transform their financial and clinical models
  • Improving health of populations through activities focused on engaging beneficiaries, prevention, wellness, and comprehensive care beyond the clinical setting.

These programs are expected to achieve real results: each must deliver value for patients within six months and achieve breakeven in three years.

Any organization with a well-developed idea to deliver better population health, better quality of care or reduced total cost of care should apply. While most applications will be from traditional organizations like provider groups or health systems, technology companies are particularly encouraged to apply. CMS will evaluate projects on five criteria:

  • Design of proposed service and payment models
  • Organizational capacity and management
  • Projected return on investment
  • Budget design
  • Ability to measure, monitor and report results

Letters of Intent for the program are due June 28th with final applications due August 15. The three year award period begins April 2014.  More information is available from the HCIA Round 2 website: http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.html

At CliniCast, we believe that technology has a strong role to play in supporting smarter, more cost-effective care. If you would like to know how technology might support your HCIA Round 2 application, I encourage you to contact me at jack@clinicast.net .

Jack Challis is the CEO and co-founder of CliniCast, a healthcare analytics startup building risk scores, cost scores and workflow tools to identify high risk patients, match patients to appropriate interventions and streamline workflow. By mining actionable insights from health data, CliniCast enables providers to optimize outcomes and minimize unnecessary costs.