CMMI Requests Applications for New Demonstration Project
February 7, 2014 02:32 PM
The Center for Medicare & Medicaid Innovation (CMMI) recently released a Request for Applications (RFA) for the Frontier Community Health Integration Project (FCHIP), a new demonstration project that will test new models of integrated care in the most sparsely populated rural counties. Although home health agencies are not eligible to apply directly to CMS, the program does present an opportunity for home health agencies to partner with critical access hospitals (CAHs) in certain geographic areas to “improv[e] access to, and better integrat[e] the delivery of acute care, extended care, and other essential health care services to Medicare beneficiaries.”
Authorized by Section 123 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), as amended by Section 3126 of the Affordable Care Act (ACA), this three-year demonstration project aims to “increase the availability and accessibility of services that are often not financially viable given the low patient volumes of remote and sparsely populated areas” and to “decrease the number of avoidable hospital admissions, readmissions, and avoidable transfers to tertiary facilities, such that there is no net increase in Medicare spending for the affected population.”
Because of statutory limitations included in Section 123 of MIPPA, CMS is currently only accepting applications from critical access hospitals (CAHs) located in Alaska, Montana, Nevada, North Dakota, and Wyoming and will select awardees from no more than four of these five states. However, while the primary applicant must be a CAH from one of these states, there are opportunities for other health care providers – including home health agencies – to participate in the program by partnering with a CAH.
These opportunities are outlined in CMS’ RFA. Each applicant is required to describe how it will enhance health care services in four areas to better serve the community’s needs: 1) telemedicine; 2) nursing facility care within the CAH; 3) home health services; and 4) ambulance services. Applicants who create new or expanded service delivery models that address unmet needs in the community – including increased access to quality care – will receive additional Medicare resources. In some instances, these resources may also be available to the health care providers with whom the CAH is partnering. CMS stated in the RFA, for example, that it would make “an enhanced payment rate available to home health agencies to account for the costs to travel extended distances to render home health services to patients.”
Applicants interested in participating in this program must include letters of commitment showing support for the proposed clinical and financial arrangements from partner organizations, including home health agencies, rural health clinics, nursing facilities, and state Medicaid agencies. CMS has indicated that applicants that omit these types of providers from their models “must document either that no such provider exists in the community or that the provision of the services of such provider type is adequate to meet current needs.”
Although this project will be deployed on a relatively small scale, it presents an exciting opportunity to get involved with CMMI’s ongoing efforts to develop and test new payment and delivery system models. Further, the results of this project will inform the ongoing policy dialogue on the value of home and community-based care settings.
Applications are due to CMMI by 5 pm on May 5, 2014. Please contact Richard D. Brennan, Jr., MA, NAHC’s Vice President of Technology Policy and Government Affairs, at email@example.com for additional details.