I’ve been thinking a great deal about the newly formed Center for Medicare and Medicaid Innovation. (CMI). This entity was established as a result of the Affordable Care Act (the new healthcare reform legislation) and its purpose is to “research, develop, test and expand innovative payment and service delivery models that will improve the quality and reduce the costs of care for” patients covered by CMS-related programs. The legislation gives this entity over $10 billion dollars initially and broad authority to figure out new ways of doing things better and differently than before. What is great about CMI is that they have the authority to run their programs much more like a business would without many historical governmental constraints. That’s great news for innovation, which is sorely needed in the U.S. healthcare system.
Among the key objectives that the administration has discussed is how to transition the collective mindset from one of healthcare to one of health. In other words, if a person is healthy, they do not need health CARE. This is a very important distinction; it puts the emphasis on prevention and wellness as opposed to what you do when somebody is already sick. In order to affect such a transition, there must be an emphasis on innovation to change the way we have traditionally looked at the healthcare world.
This is an interesting challenge and one that requires a great deal of thoughtfulness in how to approach the universe of innovation opportunities. As venture capitalists, I and my colleagues vet, select and monitor deals and specifically focus on how we pick winners and avoid losers. It’s a little like being asked to handicap who’s going to win the World Series, but then again, that is pretty much our job as VCs: to act like Billy Beane and pick those most likely to succeed in a capital efficient way based on detailed analysis of trends and meaningful data, not solely based on experience.