The Patient Protection and Affordable Care Act (ACA) was a monstrous piece of legislation with a laundry list of goals. While ‘Obamacare’ and healthcare.gov woes have received much of the spotlight since the law’s passage, the ACA actually included important tools towards reforming the way that care is delivered – efforts that have been quietly funded over the last several years.  Earlier this month, the Administration indicated a desire to renew its focus on these delivery system reforms in the coming year.

These efforts are largely being coordinated and funded by the Center for Medicare and Medicaid Innovation (CMMI) within the Centers for Medicare and Medicaid Services (CMS). CMMI was created by the ACA, has flexible authority to test approaches that hold the promise of improving health care delivery and health outcomes with the same or fewer dollars, and was armed with $10 billion to do so. What’s even more striking still is that the Department of Health and Human Services (HHS) has the authority to expand new methods to the entire Medicare and Medicaid programs without the approval of Congress.

CMMI has already made significant investments in a number of innovative models and initiatives, including Accountable Care Organizations, Bundled Payments, Patient Centered Medical Homes, State-Based Innovation Models, among others.

CMMI has come under fire for a number of reasons – testing too many approaches, not testing them fast enough, not testing them the right way.

In recent weeks, however, health advisors to the President have indicated that renewed attention will be given to innovations in 2014 already underway towards the goal of rewarding the provision of quality health care and the reducing costs.