Focus on Health Care Reform: New Administrative Offices

The Department of Health and Human Services (HHS) has created many new offices and staff teams to implement provisions of the Affordable Care Act (ACA). The Centers for Medicare & Medicaid Services (CMS) has also undergone some reorganization in order to enact the many reforms, pilot programs and demonstration projects set for implementation in the coming years. Below you’ll find a list of new key offices within HHS and CMS that were created by the ACA and will help implement the new law.

Center for Medicare

This Center combines the operations of the Medicare fee-for-service program, Medicare managed care and the Medicare prescription drug benefit. The Center for Medicare is responsible for the CMS proposed rulemaking on the shared savings/ACO pilot that will begin in 2012.

Center for Medicare and Medicaid Innovation

The CMS Center for Medicare and Medicaid Innovation (CMMI) will test new payment and care delivery models with the goal of reducing program expenditures and improving the quality of patient care. The Center is charged with giving preference to those that improve coordination, quality and efficiency of health care services to Medicare and Medicaid beneficiaries.

The CMMI is expected to announce its plans for providing technical assistance directly to physicians—specifically those in smaller practices—to help them participate in ACOs. This effort is separate from and in addition to the ACO/shared savings pilot program authorized in the ACA.

Office of Consumer Information and Insurance Oversight (OCIIO)

The OCIIO is tasked with implementing the ACA’s private insurance reforms.  According to HHS, the “office is responsible for ensuring compliance with the new insurance market rules, such as the prohibitions on rescissions and on pre-existing condition exclusions for children that take effect this year. It will oversee the new medical-loss ratio rules and will assist states in reviewing insurance rates. It will provide guidance and oversight for the state-based insurance exchanges. It will also administer the temporary high-risk pool program and the early retiree reinsurance program, and compile and maintain data for an internet portal providing information on insurance options.”

Office of Delivery System Reform

This office will oversee efforts to promote payment and delivery reforms, such as accountable care organizations (ACOs).  While these pilots and demonstrations will be directly implemented by CMS, the Secretary has wide discretion on many key aspects of these reforms.

Center for Strategic Planning

The Center oversees the Office of Research, Development, and Information (ORDI), which is responsible for CMS demonstration projects such as the ongoing acute care episode bundling demonstration and the physician group practice demonstration. ORDI will oversee new payment and delivery demonstration projects authorized by the ACA, such as bundling and the medical home.


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