Boehler takes helm at Center for Medicare and Medicaid Innovation

Health and Human Services Secretary Alex Azar has appointed Adam Boehler, founder and former CEO of home-based medical care services vendor Landmark Health, to be director of the Center for Medicare and Medicaid Innovation.

Boehler, who joins HHS this week, brings a wealth of entrepreneurial experience to his job as head of CMMI.

In addition to Landmark Health, he is the founder of Avalon Health Solutions, a laboratory benefit management services company, as well as TrellisRx, a vendor that partners with health systems to fund, build and operate specialty pharmacies. Boehler was also an operating partner at Francisco Partners, a global private equity firm focused on healthcare technology and services investing.

He takes the helm of CMMI during a potentially volatile time for the center. Created by the Affordable Care Act to test innovative payment and service delivery models to reduce program expenditures while preserving and enhancing the quality of care, CMMI has come under fire from the Trump administration for dictating to physicians and other providers how they must practice.

CMS Administrator Seema Verma announced late last year that the agency will be leading CMMI in a new direction that will promote greater flexibility and patient engagement.

“We recently issued a Request for Information to collect ideas on the best path forward for the Innovation Center,” Verma said during the Health Care Payment Learning and Action Network (LAN) Fall Summit held in late October 2017. “We’re moving away from the assumption that those in Washington can engineer a more efficient healthcare system. Washington is unfamiliar with the nuances of local communities and is not at the center of private market innovation. Instead, we want to launch models that give people on the frontlines the flexibility to be creative and transformative.”

According to Verma, CMS’s vision is to develop models that promote a patient-centered system of care within a market-driven healthcare system.

“Models should empower consumers to make decisions that are right for them and providers should compete around value and quality,” added Verma. “We want patients to be activated shoppers and need to make sure they have the information and the incentives to make decisions that are right for them.”

Also See: Fed initiative to put patients in control of their health data

In response to the CMS Innovation Center Request for Information, the American Medical Informatics Association urged Verma to not only focus on payment reforms, but also put a greater emphasis on the interdependency of payment and delivery reforms supported by informatics.

“Whether considering computational models to extract data from free text to reduce clinician burden, or risk stratification of patient populations by including social determinants of health data, or the integration of consumer-based technology into care decisions, an informatics infrastructure and workforce will underpin both the intervention and measurement of care,” wrote the group in a November 2017 letter to Verma. “As such, AMIA strongly recommends CMMI leverage new models and pilots to further promote and optimize the use of informatics tools and capabilities to support patient care.”

Likewise, HIMSS in its response to the RFI noted that “health information and technology are essential, foundational elements of meaningful transformation of our nation’s health system, capable of supporting care coordination, improvement of care quality, enhancing the patient experience, enabling clinicians to work at the highest levels of their licensure, containing costs, standardizing evidence-based model practices, expanding access to care and optimizing the effectiveness of public payment.”