Serious Illness Recommendations to the Center for Medicare and Medicaid Innovation

Last year, the Center for Medicare and Medicaid Innovation (CMMI) reformulated its strategic vision and released a “strategy refresh,” emphasizing population accountability, person-centered care, and health equity, among other priorities. This new strategy provided many opportunities to advance payment for palliative care as well as targeted improvements in the care of Medicare beneficiaries living with serious illness, and both CAPC and the National Coalition (“the Coalition”) have been sharing information and recommendations with key CMMI staff in response. This includes efforts last fall recommending specific quality measures in all models, together with guidance for defining the population living with serious illness in claims data.

Following that, in January of 2022, CAPC submitted recommendations to advance health equity during serious illness, and conducted a series of educational sessions with both CMMI staff and Medicare Advantage plans on racial inequities during serious illness and what can be done to reduce disparities. More recently, in May 2022, the Coalition submitted recommendations for highlighting palliative care in accountable care models such as the ACO Reach model, and CAPC then shared case studies on some successful ACO approaches later that month. We look forward to continuing to share our findings and recommendations.