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Suggested Citation:"6 Conclusion." National Academy of Medicine. 2022. Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation. Washington, DC: The National Academies Press. doi: 10.17226/26675.
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Page 31
Suggested Citation:"6 Conclusion." National Academy of Medicine. 2022. Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation. Washington, DC: The National Academies Press. doi: 10.17226/26675.
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Page 32

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6 CONCLUSION During the first phase of the Catalyzing Health Innovative Health Transformation initiative, CMMI was undertaking its strategic and operational planning process in alignment with the Biden-Harris administration’s health and health care agenda. In early 2021, the Biden-Harris administration highlighted areas including tackling the converging crises of the COVID-19 pandemic, advancing ra- cial equity, and expanding access to quality affordable health care (The White House, 2021). After completing the first phase of this project, CMMI’s culminating Innovation Center Strategy Refresh cited the NAM Expert Panel Review as a validating factor in mov- ing CMMI toward re-examining its portfolio of efforts to acceler- ate health system transformation and the adoption of value-based care (CMMI, 2021). Throughout the second project phase, CMMI continued to provide active counsel and input on discussions to in- form its strategy implementation efforts, particularly its efforts to evaluate the limits of their statute, signal upcoming developments on multi-payer alignment efforts, and refine the approach to col- lecting equity data in support of payment policy to account for the equity, cost, quality, and degree of systems transformation. While the strategies, programs, and models presented in this publication outline discuss the gaps and solutions related to pro- moting value-based care and the need to collect and apply data to support equity, it does not place in stark terms the grave reality of the nation’s overall health and the state of the health care system. For example, the health system is not achieving the basic aims of care access, administrative efficiency, equity, and health care out- comes. Each is among the lowest compared to other more econom- ically developed countries (Tikkanen and Abrams, 2020). More concerningly are the outcomes of the nation’s current health and 35

36 | Catalyzing Innovative Health System Transformation health care system. In 2020, U.S. life expectancy fell by one year, driven by the high mortality rate of Black and Latino/a populations during the COVID-19 pandemic (Andrasfay and Goldman, 2021). Where federal efforts to build on the advancements of the Afford- able Care Act have stalled, it is more critical that CMMI’s impact broadens to meet the challenges of today. CMMI has the potential to catalyze the use of science and policy and create the necessary innovation and advancements to transform the nation’s health and health care system. If it accomplishes this goal, it will have changed the paradigm of health and health care to include coordi- nating stakeholders toward adopting value-based care models and collecting data to support equity, embedding upstream drivers of health services and supports in its future programs, and creating the incentives and policies to finance and reward quality, value- based care. Paramount is that these efforts translate into tangible results that impact the lives, experiences, and health of the na- tion’s beneficiaries of health and health care. PREPUBLICATION COPY - Uncorrected Proofs

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Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume.

This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI’s Strategic Refresh.

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