CMS Innovation Center Signals Its Next Moves To "Make America Healthy Again"

On May 12, CMS published a white paper signaling its priorities under the new Administration, authored by Innovation Center (CMMI) Director Abe Sutton. The paper was followed the next day with a public webinar with CMS Administrator Dr. Mehmet Oz.

The strategy sets up three inter-related pillars:

1. Promote evidence-based prevention. Reflecting the Make American Healthy Again (MAHA) focus on physical activity and good nutrition to promote healthy lifestyles and mitigate diseases, CMMI plans to embed preventive care incentives and measures into every model.
2. Empower people to achieve their health goals. CMMI hopes to improve patients' access to cost and quality data, increase provider transparency (via public reporting) across all models, and examine the impacts of data sharing tools. Sutton acknowledges past projects, such as Blue Button, that made progress previously along similar lines.
3. Drive choice and competition. CMMI pledges to simplify model designs to reduce administrative burden and increase alternative payment model (APM) adoption among provider types that have historically under-participated in CMMI models (e.g., rural providers, independent providers, and home- and community-based providers).

The three pillars are all said to support the Trump Administration's mission to reduce federal spending and ensure that CMMI models achieve savings. Sutton notes that CMMI "has made investments in the necessary infrastructure to support broad system reform" and will now refocus the priorities of its APMs to promote healthier lives for beneficiaries to reduce expensive or avoidable utilization and generate model savings. CMMI will be more aggressive in garnering cost savings by requiring all models to have downside risk and require all model participants to adopt some level of financial risk, which may make its goal of increasing APM adoption among independent, small, and rural providers difficult to achieve.