Brad Smith, most recently chief operating officer of Anthem’s Diversified Business Group, will become the new director for the Center for Medicare & Medicaid Innovation (CMMI). Smith is the co-founder and former CEO of community-based palliative care provider Aspire Health, a potential signal that palliative care could become a CMMI priority.
CMMI is the component of the U.S. Centers for Medicare & Medicaid Services (CMS) tasked with developing and testing new payment models and health care delivery systems. In addition to his position as CMMI director, U.S. Health & Human Services (HHS) Secretary Alex Azar tapped Smith as senior advisor for value-based transformation.
“Brad will help HHS and CMS continue and accelerate the value-based transformation work that we have begun under President Trump,” said Azar said in a statement. “Paying for outcomes rather than procedures through CMMI models is an important tool for the value-based transformation of health care that President Trump has prioritized. Brad has impressive experience with innovative care delivery and paying for value, and he will help expand [CMS Administrator Seema Verma’s] and CMS’s efforts to ensure Medicare and Medicaid beneficiaries are getting better care, and better health, at a lower cost.”
A key initiative for CMMI is development and implementation of the Primary Care First payment models that were announced in 2019 and set to be implemented in January 2021. The models — which include a general payment option, a Serious Illness Population model, and several direct contracting models — have significant implications for hospice and palliative care providers. Some in the field have speculated that the payment models could boost hospice and palliative care providers’ margins by as much as 20-25% for those services.
Primary Care First and the forthcoming Medicare Advantage hospice carve-in mark the hospice industry’s first steps away from fee-for-service payments towards value-based models. With Smith’s role as senior advisor for value-based transformation, this movement could accelerate or expand.
Some leaders in the field welcomed Smith’s appointment.
“We are thrilled that Brad Smith, a steadfast advocate for value-based, person-centered care, will serve as the next head of CMMI,” said Coalition to Transform Advanced Care Co-Founder and Co-Chair Tom Koutsoumpas. “Brad has been a tremendous friend and ally, working hand-in-hand with C-TAC and creating transformative care models designed to support people with serious illness.”
Key members of Congress also hailed Smith’s appointment, including U.S. Senate Health Committee Chairman Lamar Alexander (R-Tenn.).
“Brad has exactly the right experience to lead a center charged with coming up with innovative ways to lower health care costs and improve quality,” Alexander said in a statement. “He has founded a successful health care company and knows how state and federal governments work, having served under [former Republican Governor of Tennessee] Bill Haslam and Senator Bob Corker [R-Tenn.], and at the White House.”