The Center for Medicare and Medicaid Innovation (CMMI), part of the Centers for Medicare and Medicaid Services, operates as a “policy laboratory” to test new payment and service delivery models in Medicare and Medicaid. Michael Baker, Director of Health Care Policy, recently provided insight into CMMI’s current function, recent model announcements, and its significance as the Trump Administration uses its waiver and demonstration authority to advance health policy objectives.
According to Baker, “CMMI’s mandate is to test payment and service delivery models that reduce program expenditures while preserving or enhancing quality, and prioritizing models that improve care coordination, quality, and efficiency.” He noted that since CMMI’s creation, it has received criticism from lawmakers and industry representatives regarding issues such as bypassing legislative processes, inefficient model designs, and unsatisfactory fiscal outcomes for Medicare.
Looking ahead to 2025, CMMI plans to focus on new initiatives. These include models related to GLP-1 usage in diabetes treatment, Most-Favored-Nation drug pricing strategies intended to lower medication costs by benchmarking prices against those paid internationally, as well as broader Make America Healthy Again programs. Baker emphasized the importance of understanding how these models work within the agency’s mission.
These developments highlight ongoing debates about the effectiveness of CMMI’s approach in achieving both cost savings and improved care quality within federal health programs.
