Eliminating CMMI Is a Win for Republicans
If the government excels at anything, it's spending taxpayer money as if dollar bills grow on trees. Washington politicians fund one bad decision after another – not on their dime, but on yours – without thinking twice. And while this pattern has become all too familiar, federal bureaucrats still find ways to funnel billions of dollars into programs that offer zero benefit for Americans, including Medicare and Medicaid patients and providers.
One of the most glaring – and least understood – examples is the Centers for Medicare and Medicaid Services’ (CMS) innovation arm: the Center for Medicare and Medicaid Innovation (CMMI). Launched in 2010 under the Affordable Care Act, CMMI was supposed to be the solution to a healthcare system facing soaring costs and declining quality by experimenting with government-designed payment models. These models were sold as a means to expand access and improve care for the nation's most vulnerable patients, while also saving taxpayer money.
More than a decade later, the results tell a very different story. Unsurprisingly, granting unaccountable bureaucrats uncontrolled and unchecked authority over healthcare policy has yielded the very opposite results that the program intended.CMMI has failed to improve patient care and instead added layers of confusion. Not only are the program’s models often mandatory, inflicting unexpected changes and disruptions to care, but they are also dense with jargon and technicalities. These complexities and wide-ranging changes discourage provider participation and limit meaningful feedback from those delivering care on the ground.
Beyond sidelining providers from the care conversation, CMMI also puts agenda-driven bureaucrats, not patients, at the forefront of care decision-making. These individuals operate unchecked within the agency, single-handedly determining how care is delivered to millions of Americans, without input from patients or Congress. Drowning out patient voices in favor of partisan priorities is a hallmark of Washington mismanagement and fails the people this program claims to serve.
It’s clear that this so-called “innovation” produced by CMMI has only succeeded in reducing patient choice by distorting provider incentives and limiting access to care. Many CMMI models follow a fixed-payment structure rather than traditional payment-per-service methods. When resources are constrained under these fixed payments, hospitals and providers are financially incentivized to favor healthier, less complex patients, as they do not want to spend excessive amounts of money on more nuanced or specialized treatments. This selective pressure leaves the sickest and most vulnerable individuals with fewer options – making CMMI yet another barrier to care, not a solution.
Furthermore, the staggering cost of this failed program speaks for itself. Between 2011 and 2020, the Congressional Budget Office (CBO) found that, rather than saving taxpayers money, CMMI lost $5.4 billion due to funding models that failed to offer patients substantial benefits or cost relief. A 2021 analysis found that only 4 of 172 Medicare models were eligible for expansion. Yet, despite this disappointing track record, costly models continue to be pumped through the program in hopes that the next attempt might actually succeed.
There is nothing innovative about a wasteful program that fails to meet basic measures of success and leaves patients in a weaker, more constrained system of care. In fact, it’s regressive. Programs like CMMI’s recently introduced GLOBE and GUARD models create uncertainty and confusion for both patients and providers, and can hardly be upheld as examples of the government successfully addressing healthcare challenges. Previous records show these models rarely do.
Fixing a broken system is not a contentious issue. American patients deserve transparency, and this can begin with an acknowledgement that CMMI is in dire need of reform. The program has strayed far from its original mandate and operates freely with little accountability.
If outright elimination is not on the table, Congress needs to rein in this program by enforcing stronger oversight authority, limiting the use of mandatory fixed-payment models, and imposing clear standards to measure patients' outcomes and fiscal performance. Otherwise, the cycle will continue at the expense of patients’ health and wallets.
Jon Decker is the Executive Director of American Commitment.
If the government excels at anything, it's spending taxpayer money as if dollar bills grow on trees. Washington politicians fund one bad decision after another – not on their dime, but on yours – without thinking twice. And while this pattern has become all too familiar, federal bureaucrats still find ways to funnel billions of dollars into programs that offer zero benefit for Americans, including Medicare and Medicaid patients and providers.
One of the most glaring – and least understood – examples is the Centers for Medicare and Medicaid
Services’ (CMS) innovation arm: the Center for Medicare and Medicaid Innovation (CMMI). Launched in 2010 under the Affordable Care Act, CMMI was supposed to be the solution to a healthcare system facing soaring costs and declining quality by experimenting with government-designed payment models. These models were sold as a means to expand access and improve care for the nation's most vulnerable patients, while also saving taxpayer money.
More than a decade later, the results tell a very different story. Unsurprisingly, granting unaccountable bureaucrats uncontrolled and unchecked authority over healthcare policy has yielded the very opposite results that the program intended.
CMMI has failed to improve patient care and instead added layers of confusion. Not only are the
program’s models often mandatory, inflicting unexpected changes and disruptions to care, but they are also dense with jargon and technicalities. These complexities and wide-ranging changes discourage provider participation and limit meaningful feedback from those delivering care on the ground.
Beyond sidelining providers from the care conversation, CMMI also puts agenda-driven bureaucrats, not patients, at the forefront of care decision-making. These individuals operate unchecked within the agency, single-handedly determining how care is delivered to millions of Americans, without input from patients or Congress. Drowning out patient voices in favor of partisan priorities is a hallmark of Washington mismanagement and fails the people this program claims to serve.
It’s clear that this so-called “innovation” produced by CMMI has only succeeded in reducing patient choice by distorting provider incentives and limiting access to care. Many CMMI models follow a fixed-payment structure rather than traditional payment-per-service methods. When resources are constrained under these fixed payments, hospitals and providers are financially incentivized to favor healthier, less complex patients, as they do not want to spend excessive amounts of money on more nuanced or specialized treatments. This selective pressure leaves the sickest and most vulnerable individuals with fewer options – making CMMI yet another barrier to care, not a solution.
Furthermore, the staggering cost of this failed program speaks for itself. Between 2011 and 2020, the Congressional Budget Office (CBO) found that, rather than saving taxpayers money, CMMI lost $5.4 billion due to funding models that failed to offer patients substantial benefits or cost relief. A 2021 analysis found that only 4 of 172 Medicare models were eligible for expansion. Yet, despite this disappointing track record, costly models continue to be pumped through the program in hopes that the next attempt might actually succeed.
There is nothing innovative about a wasteful program that fails to meet basic measures of success and leaves patients in a weaker, more constrained system of care. In fact, it’s regressive. Programs like CMMI’s recently introduced GLOBE and GUARD models create uncertainty and confusion for both patients and providers, and can hardly be upheld as examples of the government successfully addressing healthcare challenges. Previous records show these models rarely do.
Fixing a broken system is not a contentious issue. American patients deserve transparency, and this can begin with an acknowledgement that CMMI is in dire need of reform. The program has strayed far from its original mandate and operates freely with little accountability.
If outright elimination is not on the table, Congress needs to rein in this program by enforcing stronger
oversight authority, limiting the use of mandatory fixed-payment models, and imposing clear standards to measure patients' outcomes and fiscal performance. Otherwise, the cycle will continue at the expense of patients’ health and wallets.
Jon Decker is the Executive Director of American Commitment.
