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Through the collaboration of our members, the MCRA helps drive performance improvements, delivers exceptional service, transforms care, and champions the health and wellbeing of the communities our members serve. 

CMS Innovation Center Puts Accountable Care at center of 10-year Refresh Strategy

As a dynamic AI/ML platform, Radius Care is designed to persistently optimize accountable and value-based care.


Created upon enactment of the Affordable Care Act (ACA) in 2010, the Center for Medicare & Medicaid Innovation (CMS Innovation Center) was established to design, implement and test new health care payment and delivery models for Medicare and Medicaid. Managed by the Center for Medicare & Medicaid Services (CMS), the Innovation Center aims to achieve better care for patients, better health for our communities, and lower costs through the improvement of our health care system.

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At the end of 2021, the CMS Innovation Center released a strategy refresh to transform the delivery system, focus on equity, pay for health care based on value to the patient instead of volume of services provided, and deliver person-centered care that meets people where they are.

The strategy includes five pillars to advance value-based care:

  1. Drive Accountable Care

  2. Advance Health Equity

  3. Support Care Innovation

  4. Address Affordability

  5. Partner to Achieve System Transformation

Radius Care is an active health guide for Medicare members, empowering them to make better health decisions based on their health history and data-driven healthcare recommendations. The application strongly supports CMS’ push toward accountable care and Radius Care has mindfully trained its technology to continually educate and activate Medicare member’s - evolving with their health data over time. Here are some of the ways Radius Care is already aligned with this initiative and will continue to drive innovation supporting CMS’ strategy refresh:


Drive Accountable Care
  • CMS Aim: Increase the number of beneficiaries in a care relationship with accountability for quality and total cost of care.

  • Radius Care Action: Medicare members using Radius Care can grant access to family members allowing them to collaborate on the patients’ healthcare. Users can review a patient’s health history, healthcare recommendations and receive alerts anytime a patient’s health change occurs.

Advance Health Equity
  • CMS Aim: Embed health equity in every aspect of CMS Innovation Center models and increase focus on underserved populations.

  • Radius Care Action: As an AI-driven company with built in risk assessment capabilities, Radius Care organically supports an accountable care model. With deep data analysis and patient engagement reporting capabilities, it is able to identify gaps in service and provide a feed-back loop to care providers and plans where deficiencies exist.

Support Care Innovation
  • CMS Aim: Leverage a range of supports that enable integrated, person-centered care - such as actionable, practice-specific data, technology, dissemination of best practices, peer-to-peer learning collaboratives, and payment flexibilities.

  • Radius Care Action: By providing Information that revolves around the member’s profile, Radius Care is the ultimate in personalized care. The platform leverages outcomes data aggregated from other patients with similar profiles and only shares recommendations that are pertinent to the member, focusing on messaging and suggestions that truly matter and eliminating noise and misinformation.

Improve Access by Addressing Affordability
  • CMS Aim: Pursue strategies to address health care prices, affordability, and reduce unnecessary or duplicative care.

  • Radius Care Action: By reviewing outcome-based, historical healthcare data, Radius Care delivers customized guidance for cost-efficient healthcare options including alternative options for lower cost scans, tests and prescription medicines and eliminates repeat visits, unnecessary tests and procedures.

Partner to Achieve System Transformation
  • CMS Aim: Align priorities and policies across CMS and aggressively engage payers, purchasers, states, and beneficiaries to improve quality, to achieve equitable outcomes, to reduce health care costs.

  • Radius Care Action: Radius Care’s predictive data analysis is harnessed to provide not only Medicare member guidance, but also to identify inefficiencies in the care delivery continuum.

As we reflect on the past 10 years of the CMS Innovation Center, we are reminded that the road to value-based care is evolving as technology advances. CMS needs the support of companies, like Radius Care, who support or create solutions that are moving society toward care models and compensation packages centered around health outcomes. Radius Care is a healthcare solution that supports personal care helping individuals understand their unique health care challenges to implement data-driven solutions.


It is the only software approved by CMS that actively monitors a Medicare patient’s health data and, using anonymized outcome-based data from Medicare.gov, reviews historical healthcare data points and transaction details to deliver customized healthcare recommendations based on each patient’s unique needs, geographical location and ratings by healthcare service. Ultimately, saving patients and their families time and money by providing patients with a secure place to find facts and resources needed to make informed healthcare decisions.

 

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Originally Published by Radius Care on March 23, 2022

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