1. American Association of Colleges of Pharmacy
Anthony D. Rodgers
Deputy Administrator
February 2011

2. CMS Three Part Aims for Healthcare Delivery System Improvement
Better care for individuals through seamless coordinated health care.
Reduced costs through continuous improvement.
Better health for populations.

3. Strategic Aims and Priorities CMS Business Environments
Achieving CMS Three Part Aims and Priorities Through Improvements to CMS Business Environments
Strategic Aims and Priorities
CMS Business Environments
CMS Strategic Aims
Better care
Lower per capita cost
Better health for populations
Strategic Priority Areas
Excellence in operations
Improved care delivery
Integrated care
Prevention and community health
CMS Business Operations
Enterprise Management
Strategic Enterprise Planning
Policy and regulatory levers
ACA implementation
Cost containment strategies
Public Information and Customer Service
Innovation
It will be unclear to the audience what the difference is between Strategic Aims and Strategic Priority Areas

4. Sample Data Table for High-Cost HRRs (2007 Data)
A ratio for each HRRxHCC

5. Sample Data Table for Low-Cost HRRs (2007 Data)
A ratio for each HRRxHCC

6. Driving Health Care System Transformation
Healthcare Delivery System 3.0
Integrated
Health
Patient/Person Care Centered
Patient/Person centered Health Care
Productive and informed interactions between Family and Provider
Cost and Quality Transparency
Accessible Health Care Choices
Aligned Incentives for wellness
Integrated networks with community resources wrap around
Aligned reimbursement/cost Rapid deployment of best practices
Patient and provider interaction
Aligned care management
E-health capable
E-Learning resources
Healthcare Delivery System 2.0
Healthcare Delivery System 1.0
Accountable Care
Episodic
Non Integrated
Care
Transparent Cost and Quality Performance
Results oriented
Access and coverage
Accountable Provider Networks Designed Around the patient
Focus on care management
and preventive care
Primary Care Medical Homes
Utilization management
Medical Management
Episodic Health Care
Sick care focus
Uncoordinated care
High Use of Emergency Care
Multiple clinical records
Fragmentation of care
Lack integrated care networks
Lack quality & cost performance transparency
Poorly Coordinate Chronic Care Management

7. CMS AIMS
CMS aims to: 1. Measurably improve care provided to all patients in all settings while reducing cost by continuous improvement, 2. That every Medicare, Medicaid, and insured beneficiary receive seamless coordinated care, 3. That population health status is improved by organizing the delivery system and raising community health capacity.

8. CMS 2011 Focus Delivery System Transformation Patient Safety
ACO Diffusion
Medical/Health Home Diffusion
Patient Safety
Hospital Readmission Rates
Hospital Acquired Conditions Rates
Improve Care Transitions
Cost and Quality
Value Base Purchasing
Aligned Performance Incentives

9. CMS Tools for Transforming the Delivery System
Shared Savings, Episode- based Bundled Payments, Value-base payments, and Partial Capitation
ACO’s and Medical Homes
HealthCare Delivery System Transformation
Electronic Health Records and HIE
Payment Reform
Quality and Cost Transparency
Service Delivery Redesign Investments

10. Essential Elements of The Patient Centered Care of a Transformed Healthcare System
Seamless & Coordinated Care
Informed,
Activated
Patient
Productive
Interactions
Prepared
Clinical
Team
The advisory committee told us that good outcomes are the result of productive interactions between an informed, activated patient (and their family or caregivers) and a prepared, proactive practice team. This is what the chasm report calls continuous healing relationship.
Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B. A survey of leading chronic disease management programs: Are they consistent with the literature? Managed Care Quarterly. 1999;7(3):56-66
Common
Set of Patient
Health Information
Requires Electronic Health Records and Exchange of Health Information
Requires new web based
Health E-Learning, Electronic Care Planning and
Self Care Management Tools

11. An Accountable System for Beneficiary-Centered Care
Accountable Care Design Elements
Expected Outcomes
Focus on Beneficiary /Patient Quality and Cost Impact
Accountable for Continuum of Care improvements
Transformative Clinical Leadership and Governance Structure
Organized Care Management Process, Including Prevention
Alignment Around Performance and Outcome Measurements
Effective Use of Health Information Technologies
Ability to Manage Clinical Knowledge and Skills for Effective Teams
Learning Organization Able to Adapt to Change
Improved Care Coordination and Integrated Delivery of Care
Increased Provision of Evidence-Based Care
Patient Activation and Increased Health Literacy
Results In
Efficient Delivery of Care and Elimination of Waste
Reduced, Contained, and Sustained Cost of Care
Population Health Improvement

12. Discussion