Rapid reengineering of acute medical care for Medicare beneficiaries: the Medicare innovations collaborative.

In 2009 we described a geriatric service line or "portfolio" model of acute care-based models to improve care and reduce costs for high-cost Medicare beneficiaries with multiple chronic conditions. In this article we report the early results of the Medicare Innovations Collaborative, a collaborative program of technical assistance and peer-to-peer exchange to promote the simultaneous adoption of multiple complex care models by hospitals and health systems. We found that organizations did in fact adopt and implement multiple complex care models simultaneously; that these care models were appropriately integrated and adapted so as to enhance their adoptability within the hospital or health care system; and that these processes occurred rapidly, in less than one year. Members indicated that the perceived prestige of participation in the collaborative helped create incentives for change among their systems' leaders and was one of the top two reasons for success. The Medicare Innovations Collaborative approach can serve as a model for health service delivery change, ultimately expanding beyond the acute care setting and into the community and often neglected postacute and long-term care arenas to redesign care for high-cost Medicare beneficiaries.