[Federal Register: September 11, 2006 (Volume 71, Number 175)]
[Notices]
[Page 53455-53456]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr11se06-88]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5043-N]
RIN 0938-ZA90
Physician-Hospital Collaboration Demonstration
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice is to inform interested parties of an opportunity
to apply to participate in a demonstration under section 646 of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003
(MMA), the Medicare Health Care Quality Demonstration, to examine the
effects of gainsharing aimed at improving the quality of care in a
health delivery system. More specifically, the demonstration will
determine if gainsharing is an effective means of aligning financial
incentives to enhance quality and efficiency of care across an entire
system of care. In contrast to traditional models of gainsharing, which
focus on the inpatient stay, this demonstration will examine approaches
that involve long-term follow-up to assure both documented improvements
in quality and reductions in the overall costs of care. Projects must
also be of sufficient size to ensure statistical robustness of the
results. CMS is particularly interested in demonstration designs that
track patients well beyond a hospital episode, to determine the impact
of hospital-physician collaborations on preventing short- and longer-
term complications, duplication of services, coordination of care
across settings, and other quality improvements that hold great promise
for eliminating preventable complications and unnecessary costs.
From the perspective of implementing and evaluating the
demonstration, we also require some standardization of gainsharing
approaches, physician payments, and hospital savings measurement across
sites. Therefore, for the Section 646 Gainsharing Demonstration, CMS
will operate projects submitted by consortia, comprising of health care
groups and their affiliated hospitals. A limited number of projects
will be operated in various geographic areas; no more than 72 hospitals
can be included across all projects.
DATES: Applications for the demonstration under MMA section 646 will be
considered timely if we receive them no later than 5 p.m., Eastern
Standard Time (e.s.t.), on January 9, 2007.
FOR FURTHER INFORMATION CONTACT: Lisa Waters at (410) 786-6615 or
GAINSHARING@cms.hhs.gov. Interested parties can obtain a complete
solicitation, application, and supporting information on the following
CMS Web sites at http://www.cms.hhs.gov/Demo[fxsp0]ProjectsEvalRpts/MD/
item[fxsp0]detail.asp?filter[fxsp0]Type=none&filter[fxsp0]ByDID=-
99&sort[fxsp0]ByDID=3&sort[fxsp0]Order=
ascending&item[fxsp0]ID=CMS1186653.
Paper copies can be obtained by writing to Lisa Waters at the
address listed in the ADDRESSES section of this notice.
ADDRESSES: Mail or deliver applications to the following address:
Centers for Medicare & Medicaid Services, Attention: Lisa Waters, Mail
Stop: C4-17-27, 7500 Security Boulevard, Baltimore, Maryland 21244.
Because of staff and resource limitations, we cannot accept
applications by facsimile (FAX) transmission or by e-mail.
Eligible Organizations for MMA 646: As stipulated in the enabling
legislation, physician groups, integrated delivery systems, or an
organization representing regional coalitions of physician groups or
integrated delivery systems are eligible to apply. A comprehensive list
of all eligibility requirements can be found in the ``Eligible
Organizations'' section of the solicitation. We envision projects that
seek to improve quality and efficiency in several areas of each
participating organization.
SUPPLEMENTARY INFORMATION:
I. Background
Section 646 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) (Pub. L. 108-173) amends title XVIII
(42 U.S.C. 1395 et seq.) of the Social Security Act to establish the
Medicare Health Care Quality (MHCQ) Demonstration Programs.
The MHCQ demonstration will test major changes to improve quality
of care while increasing efficiency across an entire health care
system. Broadly stated, the goals of the Medicare Health Care Quality
demonstration are to:
Improve patient safety;
Enhance quality of care by increasing efficiency; and
Reduce scientific uncertainty and the unwarranted
variation in medical practice that results in both lower quality and
higher costs.
II. Provisions of the Notice
This notice solicits applications to participate in the MMA Section
646 Medicare Hospital Gainsharing Demonstration that will assist in
determining if gainsharing can align incentives between hospitals and
physicians to improve the quality and efficiency of care provided to
beneficiaries over episodes of care and across settings. The focus of
each demonstration will be to link physician incentive payments to
improvements in quality and efficiency. This demonstration will provide
measures to ensure that the quality and efficiency of care provided to
beneficiaries is monitored and improved. We envision projects that seek
to improve quality and efficiency in several areas of each
participating organization.
Overall, we seek demonstration models that result in savings to
Medicare. We will assure this 3-year demonstration is budget neutral.
III. Collection of Information Requirements
This information collection requirement is subject to the Paperwork
Reduction Act of 1995 (PRA); however, the collection is currently
approved under OMB control number 0938-0880 entitled ``Medicare
Demonstration Waiver Application.''
Authority: Section 646 of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003, Public Law 108-173.
[[Page 53456]]
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: August 7, 2006.
Mark B. McClellan,
Administrator , Centers for Medicare & Medicaid Services.
[FR Doc. 06-7574 Filed 9-6-06; 1:59 pm]
BILLING CODE 4120-01-P