Looking at the Centers for Medicare & Medicaid Services Research Designs in a New Context
It’s time to take a fresh look at how the Centers for Medicare and Medicaid Services (CMS) designs its initiatives to test new models of provider payment and care delivery. As highlighted recently in the Health Affairs Blog by Tim Gronniger and colleagues, the new administration faces important choices about imposing requirements that support more rigorous and informative evaluations of new models on providers.
With the recent widespread implementation of alternative payment models (APMs), strong designs are needed more than ever to provide evidence for policy decisions about model expansion, modification, or termination for Center for Medicare and Medicaid Innovation (Innovation Center) initiatives. However, policy decisions to pursue designs with mandatory participation or random assignment can be difficult when providers resist participating in studies for which their requirements, financial incentives, and risks are not fully known in advance. The good news is that the tradeoffs between accommodating provider interests and CMS’ ability to identify worthy innovations using strong research designs may not be as stark as some have previously assumed.