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One of the Centers for Medicare Medicaid Services’ (CMS) top priorities is to foster an affordable, accessible healthcare system that puts patients first. To help achieve these goals, CMS has a powerful tool through the Innovation Center for testing ways to improve quality and reduce costs.

Background

In September 2017, CMS released a Request for Information (RFI) to collect ideas on a new direction for the Innovation Center to promote patient-centered care and test market driven reforms that:

The Innovation Center is a central focus of the Administration’s efforts to accelerate the move from a healthcare system that pays for volume to one that pays for value and encourages provider innovation.

The Innovation Center received a robust response with approximately 1,000 responses from the public, including consumers and consumer groups, physicians and other healthcare providers, health systems, health plans, national and state associations, community-based providers, foundations, faith-based organizations, states and technology firms. The responses focused on a number of areas that are critical to improving the quality of care for beneficiaries and decreasing unnecessary cost, such as increased physician accountability for patient outcomes, improved patient choice and transparency, realigned incentives for the benefit of the patient, and a focus on chronically ill patients. In addition to the themes that emerged around the RFI’s guiding principles and eight model focus areas, the comments received in response to the RFI also reflected broad support for reducing burdensome requirements and unnecessary regulations.

Next Steps

CMS is sharing the feedback received to promote transparency and facilitate further discussion of how to move the Innovation Center in a new direction. The RFI was a critical step in the model design process to ensure stakeholder input was available to help shape new models. Over the coming year CMS will use the feedback as it works to develop new models, focusing on the eight focus areas outlined in the RFI.

CMS will continue engaging with stakeholders to help foster the design and successful testing of care delivery and payment models that put patients first, reduce unnecessary burden, increase efficiencies and improve the patient experience.

Public comments that were received by the Innovation Center in response to the RFI are available below:

Additional Information

Alternate Submission Comments (PDF)

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School Improvement Program (SIP)

Improvements in the infrastructure, facilities, curriculum and extra-curricular activities are the primary focus of COMMITTED’s SIP. Program attempts to align with Nepal Government’s Department of Education’s School Improvement Plan requirement of every school.

Social Business for Education (SBE)

Social Business for Education (SBE) are agriculture-based, income-generating projects for both schools and members of the local community. Profits from the SBE are used to make the school self-sustainable as well as to support local community.

Local Governance Service Delivery (LGSD)

Local Governance and Service Delivery (LGSD) project aims to help set up local governments through tested planning, development process, and resource generation methods. The three core areas covered are service delivery, education, and economic development.

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This blog post features plans and visions of Bhimeshwor Municipality, one of the 22 municipalities that COMMITTED has been

As part of the Enhancement of Local Government Service Delivery and Economic Governance project, COMMITTED has produced

Monitoring and evaluation visit by SWC, one of the legal requirments, conducted at Taltuleshwori Primary School at its first

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The essential programs should be in your PATH at the time configure is run: this will capture the full paths.

Those distributing binary versions of R may need to be aware of the licences of the external libraries it is linked to (including ‘useful’ libraries from the next section). The liblzma library is in the public domain and X11, libbzip2 , libcurl and zlib have MIT-style licences. PCRE has a BSD-style licence which requires distribution of the licence (included in R’s COPYRIGHTS file) in binary distributions. GNU readline is licensed under GPL (which version(s) depending on the readline version).

Next: Linear algebra , Previous: Essential programs and libraries , Up: Essential and useful other programs under a Unix-alike [ Contents ][ Index ]

The ability to use translated messages makes use of gettext and most likely needs gettext : you do need this to work with new translations, but otherwise the version contained in the R sources will be used if no suitable external gettext is found.

The ‘modern’ version of the X11() , jpeg() , png() and tiff() graphics devices uses the cairo and (optionally) Pango libraries. Cairo version 1.2.0 or later is required. Pango needs to be at least version 1.10, and 1.12 is the earliest version we have tested. (For Fedora users we believe the pango-devel RPM and its dependencies suffice.) R checks for pkg-config , and uses that to check first that the ‘ pangocairo ’ package is installed (and if not, ‘ cairo ’) and if additional flags are needed for the ‘ cairo-xlib ’ package, then if suitable code can be compiled. These tests will fail if pkg-config is not installed 53 , and are likely to fail if cairo was built statically (unusual). Most systems with Gtk+ 2.8 or later installed will have suitable libraries

For the best font experience with these devices you need suitable fonts installed: Linux users will want the urw-fonts package. On platforms which have it available, the msttcorefonts package 54 provides TrueType versions of Monotype fonts such as Arial and Times New Roman. Another useful set of fonts is the ‘liberation’ TrueType fonts available at https://fedorahosted.org/liberation-fonts/ , 55 which cover the Latin, Greek and Cyrillic alphabets plus a fair range of signs. These share metrics with Arial, Times New Roman and Courier New, and contain fonts rather similar to the first two ( https://en.wikipedia.org/wiki/Liberation_fonts ). Then there is the ‘Free UCS Outline Fonts’ project ( https://www.gnu.org/software/freefont/ ) which are OpenType/TrueType fonts based on the URW fonts but with extended Unicode coverage. See the R help on X11 on selecting such fonts.

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