AAN President Bruce Sigsbee, MD, FAAN, and other Academy leaders met on January 31 with Richard Gilfillan, MD, the acting director of the Center for Medicare and Medicaid Innovation, to discuss and develop groundbreaking proposals for care and payment for Alzheimer's and stroke to reduce variation in care and decrease costs.
"CMS emphasizes that the rise in cost of federal health care programs—Medicare, Medicaid, and CHIP—is unsustainable," said Sigsbee. "They are looking to the medical community to develop programs, such as ACOs, that improve outcomes, improve quality, and reduce costs. Going forward, the financial incentives will be directed to those organizations that address all three goals. As neurologists, we need to position our practices to succeed in this environment."
Sigsbee was joined at the meeting by AAN members Neil A. Busis, MD, FAAN; Jonathan P. Hosey, MD, FAAN; and Amy E. Sanders, MD, MS. They conveyed the Academy's interest in developing a working relationship with the Innovation Center and show that neurologists provide high-quality, cost-effective care. The group stressed that neurologists should be involved in testing new care and payment models.
"Dr. Gilfillan noted that neurologists are not part of the problem of escalating costs but diseases we take care of such as stroke and dementia are major cost drivers," said Sigsbee.
The AAN's proposed stroke model involves clinical-decision support tools for giving t-PA and telemedicine. The AAN knows there are many more approaches to take with stroke care and will expand to develop more models in future phases.
"Our Alzheimer's disease proposal combined a physician team-based approach with a coordinated care model for mid-level providers," said Sanders. "The proposal included a prominent focus on caregiver education and support. We think that our proposal succeeded in addressing the three areas most central to the Innovation Center's mission: better health, better care, and better costs."
The Center for Innovation promotes itself as "a new engine for revitalizing and sustaining Medicare, Medicaid, and the Children's Health Insurance Program and ultimately for improving the health care system for all Americans. The Innovation Center has the resources and flexibility to rapidly test innovative care and payment models and encourage widespread adoption of practices that deliver better health care at lower cost."
AAN members who seek more information or who have innovated care in their practices or communities can share their work by contacting Amanda Becker at email@example.com.