Care and Payment Innovation
MISSION Act Section 152, 1703E
VIC-CPI portfolio is focused on implementing care and payment innovation authorized by VA MISSION Act, Section 152. 1703E. Passage of the MISSION Act authorized the creation of a center for care and payment innovation focused on achieving cost savings without hurting quality. The Secretary, acting through the Center, may carry out such pilot programs the Secretary determines to be appropriate to develop innovative approaches to testing payment and service delivery models to reduce expenditures while preserving or enhancing the quality of care furnished by the Department. Per statute, the Secretary has directed VA’s Innovation Center (VIC), in the Office of Enterprise Integration (OEI) to establish the Center.
Mission Act Videos
Authorities and Provisions
- DURATION: Each pilot program carried out by the Secretary under this section shall terminate no later than 5 years after the date of the commencement of the pilot program.
- BUDGET: Funding for each pilot program carried out by the Secretary under this section shall come from appropriations provided in advance in appropriations acts for the Veterans Health Administration; and provided for information technology systems.
- LIMITATIONS: The Secretary may not carry out more than 10 pilot programs concurrently and may not expend more than $50,000,000 in any fiscal year. However, the Secretary may expend more than $50,000,000 if — (i) the Secretary determines that the additional expenditure is necessary to carry out pilot programs under this section; (iii) the Chairmen of the Committees on Veterans’ Affairs of the Senate and the House of Representatives transmit to the Secretary a letter approving of the additional expenditure.
- WAIVERS: In implementing the pilot programs under this section, the Secretary would be authorized to waive such requirements in subchapters I, II and III of chapter 17 of title 38, U.S.C., as may be necessary solely for the purpose of carrying out this section with respect to testing models under this program.
- EVALUATION: The Secretary would be required to conduct an evaluation of each model tested, to include, at a minimum, an analysis of the quality of and access to care furnished and the changes in spending by reason of that model. The Secretary would be required to make each evaluation available to the public in a timely fashion.
- EXPANSION: The Secretary would be authorized to expand, through rulemaking, the duration and scope of successful pilot programs to the extent the Secretary determines that such expansion is expected to reduce spending without reducing the quality of or access to care or improve the quality of or access to care without increasing spending; the Secretary would also have to determine that such expansion would not deny or limit the coverage or provision of benefits for applicable individuals.
Objectives and Key Factors
Test payment and service delivery models to determine whether such models improve access to, and quality, timeliness, and patient satisfaction of care and services; and create cost savings for the Department. Service delivery and payment innovation pilot demonstrations will be designed to integrate several key factors and desired outcomes.
|Key Factors||Access||Quality||Timeliness||Patient Satisfaction||Cost Savings|
|Deficits in Care||Checked||Checked||Checked||Checked||Checked|
|Monitoring and Updating Care Plans||Checked||Checked||Checked||Checked||Checked|
|Technology Enabled Care Coordination||Checked||Checked||Checked||Checked||Checked|
|Effective Linkage with other Payers||Checked||Checked||Checked||Checked||Checked|
(5 years minimum)