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  • Washington Highlights

    CMMI Specialty Engagement Strategy Update


    The Center for Medicare and Medicaid Innovation (CMMI) released an update to their 2021 strategic refresh, outlining progress and goals for integrating specialty care into accountable care arrangements with the goal of creating longitudinal and coordinated care relationships.  

    With regards to enhancing specialist performance data, the CMMI has implemented two main strategies. The first is the introduction of shadow bundles, which is additional accountable care organization data that allows an institution to view claims in episodic bundles that do not bear risk. This allows providers to create care interventions targeted at lowering costs and improving quality. The AAMC supports this work and will be launching a new Shadow Bundle Collaborative for members interested in tracking their claims data.  

    Second, the CMMI is launching the new Making Care Primary (MCP) Model, which will provide specialist performance profiles. Turning to the center’s second goal around the continuation of specialty-focused episodic models, a mandatory model is likely to launch in 2026, which will engage specialists. The AAMC submitted a response in 2023 to the CMMI’s request for information regarding this new model. Lastly, looking at both the financial incentives for primary care and specialty providers, the center is focusing on the upcoming MCP and mandatory models as key drivers of specialty engagement. Incentives will also be incorporated into future models to encourage a strong relationship between primary care providers and specialists.