Tuesday, January 7, 2020

Anthem Executive to Lead CMMI

Anthem executive Brad Smith has been appointed to head the Center for Innovation (CMMI) at CMS, announced January 6, 2020.

During the Trump administration, CMMI was headed by Adam Boehler until October 2019.   Boehler moved from CMS to head the U.S. International Development Finance Corporation (here).  Prior to CMS, Boehler had started Landmark Health, which aimed to assist Medicare Advantage and other plans in managing chronic disease better.

Long-time CMS executive Amy Bassano had been acting director of CMMI since last fall.

Interestingly,  Smith was CEO of Aspire Health (founded by former Senator Bill Frist), which provided home services to patients with complex and chronic illnesses, not too different from Boehler's background with Landmark.  Smith, a Harvard graduate, was a Rhodes scholar.  According to one news source, the head of CMMI oversees 600 employees.

Trade journal stories include:

  • Healthcare Dive here.
  • Modern Healthcare here.
  • The Tennessean here.
  • CMS press release here.

While CMMI is commonly described as having bipartisan support, in fact there were Hill hearings in 2016 that were highly confrontational and concerns that CMMI's authorities might exceed statutory limits.  For example, CMMI is allowed to set up "demonstration programs" by law (in the ACA), but there is no written restriction on the size, scope, duration, or content of the demo programs.   CMMI's statutory authorization is just a few sentences long and has been viewed as self-implementing.