With a new administration comes a new strategic direction for the Centers for Medicare and Medicaid Innovation (CMMI).

On May 13, CMMI Director Abe Sutton walked through the three pillars of the strategy: promote evidence-based prevention, empower people to achieve their health goals, and drive choice and competition. This aligns with the Make America Healthy Again initiative focusing on disease prevention and chronic disease management.

CMMI will continue to build upon lessons learned to date but will ensure that prevention is embedded in all the models and will look to test and scale models across Medicare, Medicare Advantage, and Medicaid and align incentives across payers.

While goals continue to include reducing the cost of health care, the strategy to achieve it will shift to preventing and detecting disease early and better chronic disease management. CMMI wants to engage more providers in these efforts.

This new strategy has the potential to create opportunities for post-acute, long-term services and support, and community-based providers to engage in CMMI models more meaningfully as they focus on new outcome metrics (e.g., time patient spends at home) and new payment incentives such as creating patient-centered payments, advanced payments, and other payment mechanisms that would support a wider array of participating providers.

However, CMMI also seeks to shift more financial risk onto providers and promote site-neutral payments across settings. The latter could lead to testing or implementing the unified post-acute care (UPAC) prospective payment concept from the IMPACT ACT, where payment is tied to the needs of the patient vs. the setting where those needs are addressed.

LeadingAge has expressed concerns about the modeling conducted to date on UPAC. Sutton noted that they will be announcing listening sessions soon and are interested in stakeholder engagement to inform future models and modification to existing models.

LeadingAge will continue to monitor CMMI activities and share ideas we have for how our members can assist in CMMI’s goals.