Health and Science

Want $840 million? Think up fresh ways to help patients

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You can call this "Shark Tank" for health care.

The federal government announced Thursday it will award up to $840 million over the next four years to applicants who come up with ways to improve medical care and cut overall health costs.

Successful applicants will work with health-care providers to "rethink and redesign" their medical practices to focus on reaching the best medical outcomes for patients and coordinating treatment of them, officials said.

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They hope the program will lead to $1 billion to $4 billion in cost savings over that period, and encourage adoption of the the enusing new strategies by other medical providers. About 150,000 clinicians would benefit from support for the strategies developed by the program, according to the Health and Human Services Department.

"One of the goals of this initiative is preventing 5 million unnecessary hospitalizations," said Dr. Patrick Conway, deputy administrator for innovation and quality at the Centers for Medicare and Medicaid Services, a division of HHS.

"This is an investment in clinicians' ability and desire to transform their practices," said Conway. CMS started accepting applications for the program Thursday.

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"This model will support and build partnerships with doctors and other clinicians across the country to provide better care to their patients. Clinicians want to spend time with their patients, coordinate care and improve patient outcomes, and [CMS] wants to be a collaborative partner helping clinicians achieve those goals and spread best practices across the nation," Conway said.

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The initiative is in line with a main goal of the Affordable Care Act—to spur the nearly $3 trillion health-care system to move from a model of getting paid for services provided to one that rewards patient outcomes, a so-called fee-for-value model.

The current fee-for-service model is blamed for the U.S. spending a disproportionately large amount of money per person on health compared to other industrialized countries while getting worse results in many health-care categories than those countries see.

"By participating in the initiative, practices will be able to receive the technical assistance and peer-level support they need to deliver care in a patient-centric and efficient manner," HHS said in a statement announcing the program.

'More work to be done'

Health-care systems, group physician practices, medical providers associations and others can apply.

The department also said strategies that would receive funding might include ones that give "doctors better access to patient information;" increase the number of ways that patients can communicate with a team of health-care providers overseeing their treatment; improving coordination for caring for patients; and use electronic medical records daily to track how well and efficiently the patient is being cared for.

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In a fact sheet about the initiative, CMS said: "To date, there have only been small-scale investments in a collaborative peer-based learning initiative. CMS estimates that about 185,000 clinicians currently participate in existing programs, models, and initiatives that facilitate practice transformation."

"This represents only 16 percent of the nation's one million Medicare and Medicaid providers. While this is an increase over previous years, there is much more work to be done," the fact sheet said.

CMS also noted that the ACA has, with other programs, "helped reduce hospital re-admissions in Medicare by nearly 10 percent between 2007 and 2013—translating into 150,000 fewer [hospital] re-admissions—and quality improvements have resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012."

"Additionally, national reductions in adverse drug events, falls, infections, and other forms of hospital-induced harm are estimated to have avoided 518,000 patient injuries," CMS said.