CMS modernizes healthcare model tracking to spur innovation

The Centers for Medicare & Medicaid Services Innovation Center (CMMI) regularly tests new strategies that aim to achieve better care for patients, better health for our communities, and lower costs through improvement for our health care system. This generates a significant amount of data, creating opportunities for the research community to assess the impact of these strategies. The Analysis and Management System (AMS), a CMS internal resource, provides a centralized space for model data and analysis. Our bespoke solution makes model participation data available to researchers across the country for the first time through CMS’ Virtual Research Data Center (VRDC).

CMMI serves as the lead innovator for CMS healthcare models—including accountable care models, episode-payment population-based models, and disease-specific models. Over the last five years, we have partnered with CMMI to provide a tool for centralizing the collection of model information and participation data across multiple sources enabling a holistic understanding of the impact of healthcare test models within CMS. In early 2023, a new milestone was met by the Analysis and Management System (AMS) by making model participation data available from AMS to researchers via CMS’ Virtual Research Data Center (VRDC) through the CMMI Model Data Sharing (CMDS) Initiative. This is a crucial step forward in gaining more transparency and insight into innovation model participation data.

Solution

Using an agile methodology, our team of experts built a first-of-its-kind system for CMMI, called AMS, to provide regularly updated model participation files and look up specific models—for example, primary care, kidney care, bundled payments, or oncology care – within CMS. The AMS solution is three-fold – a conduit for data collection, validation, and reporting; a tool for business intelligence and analytics about CMMI models; and a data sharing initiative. It is through this data-sharing initiative that CMS has released model participation data for 14 models for researchers to use and improve patient outcomes. Within the system, CMMI teams submit their data for beneficiary attribution and provider participation—creating a place for up-to-date and validated data for internal use within CMS, and for curated up-to-date participation files for researchers to access through the CMDS initiative. AMS runs more than 520 validation checks to ensure data transparency and integrity.

Results

The CMMI AMS solution implements standardization to ensure data can be easily shared and analyzed – a goal which was realized when data began flowing through to researchers. Designed as an internal platform for model data analytics, the support of CMDS now allows AMS to share data pertaining to model participation for specific models, which is available via VRDC to authorized researchers to explore a number of key priority topics for the first time. The resulting transparency improves the ability for mission-critical care delivery and accelerated analysis.