No more 'letting 1,000 flowers bloom': 4 successes in Medicare innovation

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After over a decade, the Center for Medicare and Medicaid Innovation is turning away from "letting 1,000 flowers bloom," said Director Liz Fowler, PhD, and is focusing on narrow, proven tactics. 

Only five of CMMI's 54 released models have proven to result in savings, and only four have made their way into becoming Medicare mainstays — with most lacking significant membership and impact, according to Forbes.

Here are four conclusions CMMI has drawn over a decade of experimentation, according to Forbes:

1. Voluntary initiatives narrowed participation as only providers who saw financial gain opted in.

2. Separate alternative payment models and multiple bundles for specialty groups leads to fragmentation, taking away from value-based care. 

3. Initiatives like per-member per-month payments only temporarily work, but don't sustain new practices once phased out. 

4. In benchmarking, models need to leverage retrospective benchmarks or prospective ones with guardrails to ensure accuracy and feasibility of approaches.

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