Study: Advanced illness model offers lessons for new CMMI model

In a study published this week in Health Affairs, officials from the Coalition to Transform Advanced Care (C-TAC) and Sacramento, Calif.-based Sutter Health share lessons learned from their Advanced Illness Management model as the Center for Medicare & Medicaid Innovation prepares to implement Primary Care First, an alternative payment model that offers an implementation option focused on seriously ill patients. The CMMI model, announced in April and expected to begin next year, is based in part on the AIM model, which significantly reduced the cost of care in the last month of life while helping patients stay at home with loved ones when implemented on a large scale in California. To enhance the impact of Primary Care First on health care transformation, the authors recommend that the CMMI model prioritize patient choice of treatments; broaden the definition of care coordination to include all care settings; define serious illness as advanced illness; and define eligibility by clinical criteria. They also suggest additional ways to incentivize care transformation through payment policy and broaden participation. AHA is a member of C-TAC and supports efforts to incorporate advanced illness management into new models of care.