What role does the Center for Medicare and Medicaid Innovation (CMMI) play in payment and delivery reform?

• A. It regulates hospital charges and reimbursement ceilings.
• B. It designs and tests new delivery and payment models to evaluate their impact and potential scale-up.
• C. It sets annual budget for Medicare.
• D. It administers all CMS payment formulas.

Answer: (B)

CMMI’s role is to design and test new delivery and payment models to evaluate their impact and potential for broader use. It acts as an incubator for innovative ways to pay for care and organize care delivery, running pilots and demonstrations to see if these approaches can improve quality while lowering costs. By rigorously evaluating outcomes and comparing to standard care, CMMI identifies models that show promise for scale-up and informs CMS policy about which reforms should be adopted more widely. It’s not a regulator setting charges, not responsible for Medicare’s overall budget, and not in charge of administering all CMS payment formulas; its mission is experimentation and evidence-building to guide future payment and delivery reform.