Page:United States Statutes at Large Volume 124.djvu/416

124 STAT. 390 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(b) TESTING OF MODELS (PHASE I).— ‘‘(1) IN GENERAL.—The CMI shall test payment and service delivery models in accordance with selection criteria under paragraph (2) to determine the effect of applying such models under the applicable title (as defined in subsection (a)(4)(B)) on program expenditures under such titles and the quality of care received by individuals receiving benefits under such title. ‘‘(2) SELECTION OF MODELS TO BE TESTED.— ‘‘(A) IN GENERAL.—The Secretary shall select models to be tested from models where the Secretary determines that there is evidence that the model addresses a defined population for which there are deficits in care leading to poor clinical outcomes or potentially avoidable expendi- tures. The models selected under the preceding sentence may include the models described in subparagraph (B). ‘‘(B) OPPORTUNITIES.—The models described in this subparagraph are the following models: ‘‘(i) Promoting broad payment and practice reform in primary care, including patient-centered medical home models for high-need applicable individuals, med- ical homes that address women’s unique health care needs, and models that transition primary care prac- tices away from fee-for-service based reimbursement and toward comprehensive payment or salary-based payment. ‘‘(ii) Contracting directly with groups of providers of services and suppliers to promote innovative care delivery models, such as through risk-based com- prehensive payment or salary-based payment. ‘‘(iii) Utilizing geriatric assessments and com- prehensive care plans to coordinate the care (including through interdisciplinary teams) of applicable individ- uals with multiple chronic conditions and at least one of the following: ‘‘(I) An inability to perform 2 or more activities of daily living. ‘‘(II) Cognitive impairment, including dementia. ‘‘(iv) Promote care coordination between providers of services and suppliers that transition health care providers away from fee-for-service based reimburse- ment and toward salary-based payment. ‘‘(v) Supporting care coordination for chronically- ill applicable individuals at high risk of hospitalization through a health information technology-enabled pro- vider network that includes care coordinators, a chronic disease registry, and home tele-health technology. ‘‘(vi) Varying payment to physicians who order advanced diagnostic imaging services (as defined in section 1834(e)(1)(B)) according to the physician’s adherence to appropriateness criteria for the ordering of such services, as determined in consultation with physician specialty groups and other relevant stake- holders. Determination.