[Federal Register Volume 71, Number 175 (Monday, September 11, 2006)]
[Notices]
[Pages 53455-53456]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-7574]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5043-N]
RIN 0938-ZA90


Physician-Hospital Collaboration Demonstration

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice is to inform interested parties of an opportunity 
to apply to participate in a demonstration under section 646 of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA), the Medicare Health Care Quality Demonstration, to examine the 
effects of gainsharing aimed at improving the quality of care in a 
health delivery system. More specifically, the demonstration will 
determine if gainsharing is an effective means of aligning financial 
incentives to enhance quality and efficiency of care across an entire 
system of care. In contrast to traditional models of gainsharing, which 
focus on the inpatient stay, this demonstration will examine approaches 
that involve long-term follow-up to assure both documented improvements 
in quality and reductions in the overall costs of care. Projects must 
also be of sufficient size to ensure statistical robustness of the 
results. CMS is particularly interested in demonstration designs that 
track patients well beyond a hospital episode, to determine the impact 
of hospital-physician collaborations on preventing short- and longer-
term complications, duplication of services, coordination of care 
across settings, and other quality improvements that hold great promise 
for eliminating preventable complications and unnecessary costs.
    From the perspective of implementing and evaluating the 
demonstration, we also require some standardization of gainsharing 
approaches, physician payments, and hospital savings measurement across 
sites. Therefore, for the Section 646 Gainsharing Demonstration, CMS 
will operate projects submitted by consortia, comprising of health care 
groups and their affiliated hospitals. A limited number of projects 
will be operated in various geographic areas; no more than 72 hospitals 
can be included across all projects.

DATES: Applications for the demonstration under MMA section 646 will be 
considered timely if we receive them no later than 5 p.m., Eastern 
Standard Time (e.s.t.), on January 9, 2007.

FOR FURTHER INFORMATION CONTACT: Lisa Waters at (410) 786-6615 or 
[email protected]. Interested parties can obtain a complete 
solicitation, application, and supporting information on the following 
CMS Web sites at http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=3&sortOrder= 
ascending&itemID=CMS1186653.
    Paper copies can be obtained by writing to Lisa Waters at the 
address listed in the ADDRESSES section of this notice.

ADDRESSES: Mail or deliver applications to the following address: 
Centers for Medicare & Medicaid Services, Attention: Lisa Waters, Mail 
Stop: C4-17-27, 7500 Security Boulevard, Baltimore, Maryland 21244.
    Because of staff and resource limitations, we cannot accept 
applications by facsimile (FAX) transmission or by e-mail.
    Eligible Organizations for MMA 646: As stipulated in the enabling 
legislation, physician groups, integrated delivery systems, or an 
organization representing regional coalitions of physician groups or 
integrated delivery systems are eligible to apply. A comprehensive list 
of all eligibility requirements can be found in the ``Eligible 
Organizations'' section of the solicitation. We envision projects that 
seek to improve quality and efficiency in several areas of each 
participating organization.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 646 of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA) (Pub. L. 108-173) amends title XVIII 
(42 U.S.C. 1395 et seq.) of the Social Security Act to establish the 
Medicare Health Care Quality (MHCQ) Demonstration Programs.
    The MHCQ demonstration will test major changes to improve quality 
of care while increasing efficiency across an entire health care 
system. Broadly stated, the goals of the Medicare Health Care Quality 
demonstration are to:
     Improve patient safety;
     Enhance quality of care by increasing efficiency; and
     Reduce scientific uncertainty and the unwarranted 
variation in medical practice that results in both lower quality and 
higher costs.

II. Provisions of the Notice

    This notice solicits applications to participate in the MMA Section 
646 Medicare Hospital Gainsharing Demonstration that will assist in 
determining if gainsharing can align incentives between hospitals and 
physicians to improve the quality and efficiency of care provided to 
beneficiaries over episodes of care and across settings. The focus of 
each demonstration will be to link physician incentive payments to 
improvements in quality and efficiency. This demonstration will provide 
measures to ensure that the quality and efficiency of care provided to 
beneficiaries is monitored and improved. We envision projects that seek 
to improve quality and efficiency in several areas of each 
participating organization.
    Overall, we seek demonstration models that result in savings to 
Medicare. We will assure this 3-year demonstration is budget neutral.

III. Collection of Information Requirements

    This information collection requirement is subject to the Paperwork 
Reduction Act of 1995 (PRA); however, the collection is currently 
approved under OMB control number 0938-0880 entitled ``Medicare 
Demonstration Waiver Application.''

    Authority: Section 646 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003, Public Law 108-173.


[[Page 53456]]


(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program; 
and No. 93.774, Medicare--Supplementary Medical Insurance Program)

    Dated: August 7, 2006.
Mark B. McClellan,
Administrator , Centers for Medicare & Medicaid Services.
[FR Doc. 06-7574 Filed 9-6-06; 1:59 pm]
BILLING CODE 4120-01-P