HHS accelerates grants to create health care jobs

Sebelius welcomes Supreme Court decision to rule on health care law, saying it will help states engage in implementation.

On the day the U.S. Supreme Court announced it will hear constitutional challenges to the 2010 health care reform law, Health and Human Services Department leaders rolled out a $1 billion grant program designed to identify innovations that both improve medical care and create jobs.

HHS Secretary Kathleen Sebelius on Monday took her turn invoking the Obama administration's autumn We Can't Wait theme, using a press conference to announce the Health Care Innovation Challenge while noting that "in recent weeks, Congress has failed to act on the full jobs agenda, so we will continue to do what we can."

The new competition, Sebelius said, will award grants of $1 million to $30 million over three years to innovators who demonstrate promising new ways to deliver high-quality health care and lower costs. Health care jobs "are key to sparking the economy" she added, and the grants will help the health care community evaluate a "menu of new options for doctors and hospitals so they can provide the care they want to provide and that patients want to receive."

The grants for participants in Medicare, Medicaid and the Childrens Health Insurance Program will give priority to projects that allow health care providers to rapidly hire, train and deploy new types of workers.

The unveiling of the program was not planned around the Supreme Court's long-awaited Monday announcement that it will rule on the constitutionality of the Affordable Care Act by June 2012, Sebelius said. But she said she is pleased and confident of a favorable high court ruling, given President Obama's request for quick consideration and the majority of courts that have upheld the law's individual mandate to purchase health insurance.

"We are eager for the states to fully engage in the ongoing implementation," she said. "It's important to put to rest the notion that this law will disappear," not just for purposes of health insurance but for the sake of improving the health care system.

The grants program is the latest in a series of projects from HHS' new Center for Medicare and Medicaid Innovation designed to improve medical care while controlling costs. The innovation challenge is designed as a public-private partnership to identify future-oriented workforce approaches outside of Washington and bring them to national attention.

Projects must be capable of sustainability and rapid expansion within six months of the grant awards, which are to go out in March 2012, according to HHS.

Asked whether the timing of that evaluation is calculated around next November's election, Sebelius said the accelerated time frame is "part of using the authority we have because we can't wait for Congress to act. We have great best practices around that country that are not yet taken up to scale," she said. "We are using those resources to accelerate changes." Past CMS demonstration projects, she said, took three-to-five years to evaluate.

Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, told reporters he is excited about the grants program after having traveled to facilities in Texas, Alaska, North Carolina, Colorado and Virginia. He mentioned witnessing such workforce innovations as community partners promoting nutrition with a large health care system to combat diabetes and a church group that sends volunteers to home-bound senior citizens.

"Health care costs are linked tightly to the economic vitality of our country, and there is increasing [economic] pressure on state and local governments, businesses and families," Berwick said.

"We have come to a fork in the road," he added. "The path of cutting spending on health care looks easier," but hurts people. The other path, of saving money by improving health care, is harder, but its savings "dwarf the savings from spending cuts," he said. "If we don't innovate, we will imperil patients and our loved ones as well as our future."

Richard Gilfillan, acting director of HHS' Center for Innovation, said he already had received 500 proposals for health care workforce innovations. And though HHS has not arrived at specific number of jobs the grants might create, "there will be more people involved in health care, so it's a question of what they will be doing, and how to train and deploy them," he said. "We don't have all the answers here, but we know the answers are out there."