The Center for Medicare and Medicaid Innovation (CMMI) announced major changes in how it will approach health care innovation. Under the Trump Administration, CMMI is moving in a new direction focused on prevention, patient choice, competition, and cost savings. Health care leaders should be aware of these shifts, as they bring both new opportunities and new financial risks. Click here for AHPA’s deeper dive into how CMMI plans to activate its new policy pillars.  

The new strategy will be more focused on achieving cost savings and may include the adoption of site neutral payments – in which services are paid at the same rate no matter the setting. While the term “health equity” (a Biden Administration priority) has been removed from CMMI’s priorities, efforts to address social determinants of health will continue to be promoted. Abel Sutton, Director of CMMI, stated “Model tests may include options for working directly with individual people as well as with community-based organizations to resolve nutrition needs, provide disease management counseling and lifestyle education and services.” 

Key Takeaways for Health Care Leaders 

  • Financial risk is increasing given that providers will be asked to take on more financial responsibility for patient outcomes. Some speculate “Trump Healthcare 2.0” may even pivot from the original 2030 goal to focus on promoting risk adoption.  
  • Prevention will be a growing focus and there may be new business opportunities in preventative care and wellness services. For example, telehealth advocates are already leveraging the Make America Healthy Again (MAHA) policy priorities to expand access to virtually-delivered nutrition therapy and lifestyle medicine counseling.  
  • Artificial Intelligence and other digital tools will be key in modernizing patient data systems. 
  • Medicare Advantage may see changes in how payments and quality scores are calculated. 
  • More incentives for rural hospitals and independent practices may benefit from joining value-based care models. 

As these changes are implemented, CMMI will continue to test new programs aimed at saving taxpayer money while promoting better outcomes for patients. 

 

AHPA extends our gratitude to Aydin Mallery, guest author of this article. 
Aydin is a summer intern with Congressman Mark Takano’s Washington D.C. office.