Medicare Test Kitchen Has New Chef

The federal Medicare-Medicaid office that cooks up new projects has a new face as of April 9.

Adam Boehler, the founder and CEO of a home-based medical care company, will head the agency’s Center for Medicare & Medicaid Innovation, known as CMMI.

The four dozen or so active payment and service demonstrations under the office’s bailiwick range from the small—the Vermont All-Payer Accountable Care Organization, for example—to the more ambitious, such as the nationwide pre-diabetes prevention program.

Boehler will have to face such decisions as whether CMMI should develop a model to evaluate the exclusive use by the pre-diabetic participants of virtual services for the lessons, rather than coming to a classroom. The model would be part of efforts to promote access to telehealth services.

“Medicare innovation” has a positive ring but it hasn’t all been a bed of roses.

The CMMI caught the harsh glare of the spotlight when it proposed a large mandatory demonstration to test different methods to pay for Medicare beneficiaries’ drugs given in a doctor's office. The model was the subject of thousands of comments, mostly negative, and was never put in place.

It particularly ticked off former Health and Human Services Secretary Tom Price who said the center was “off track” and had “mandatorily been dictating to physicians how they must practice.”

The Trump administration has been focusing more on voluntary projects at the request of industry groups.

The agency in September asked the public for input on a new direction for the center. The focus was to be on eight areas, from increasing opportunities for doctors to participate in alternative payment models to ways to reduce fraud, waste, and abuse.

Although he hadn’t previously worked for the government, Boehler appears to be a good fit for an office that cooks up health-care delivery projects.

He co-founded Landmark Health, a company focused on delivering medical services to chronically ill patients.

He also founded Avalon Health Solutions, a laboratory benefit management services company, the HHS said in the announcement.

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