Lexology May 21, 2025
The Center for Medicare & Medicaid Innovation (“CMMI”) has announced a new strategy for establishing payment systems that incentivize healthier lives through a focus on three key pillars: (1) promoting evidence-based prevention; (2) empowering patients to achieve their health goals; and (3) driving choice and competition. This strategy includes several positives for providers participating (or considering participation) in CMMI’s alternative payment models, including efforts to reduce administrative burden for participants, increase predictability through reducing significant mid-model changes and increased access to prospective payments and advanced shared savings. However, CMMI has also signaled an intent to prioritize models that include downside risk, with a likely requirement that at least some of that risk is borne by providers.
Separately, CMMI Director Abe...
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