Thursday, January 6, 2022

Very Brief Blog: CMMI Grapples with "Direct Contracting" Messaging

Very early in the Biden Administration, HHS appointed long time Washington policy expert Liz Fowler as head of the Center for Innovation (CMMI) - here, here.   The potentially powerful CMMI program regularly announces a new strategic direction, most recently in October 2021 (here).   Current themes include "health equity," and "streamlining the number of CMMI models," and "encourage care delivery transformation."  They'd like to "use tools to support transformation" and achieve "high qualify, affordable, person-centered care."


I'm sensitive to whether in the lab industry we underestimate some of the underlying secular trends, such as telemedicine (Where do blood draws get taken?  Where do the samples go?) and surprise billing (new laws; but how do they change contracting for non-surprise-billing by shifting the landscape?)    While it's only a proposed model, it's seemed to me that the CMMI "Direct Contracting" models could also have rolling impacts on the lab industry.   

Despite all the other events - "January 6" and "Omicron" - direct contracting surfaces in the news this week.   See a detailed discussion at MedPageToday on January 4 by Joyce Frieden - here.  See long interview extracts online on January 3 at Advisory Board - here.   

Personalized Medicine at CMMI?

In its ten years, CMMI has generally not promoted particular technologies (like genetics) unless very broad (like telemedicine).   However, of note, the current Chief Medical Officer at CMMI is Dora Hughes MD - announcement from last summer, here.  Dr. Hughes worked for Senator Obama before 2012, and under Obama Secretary of Health Kathleen Sebelius.   She later had positions at the Sidley Austin law firm in its policy group, and then on the faculty at George Washington University. Recall that Obama had been interested in personalized medicine as early as his Senate career, and genomic medicine was a focus of then-VP Biden.