Dive Brief:
- Former Anthem executive Brad Smith has been appointed to lead CMS' powerful innovation center, the government announced Monday.
- Smith, who will also serve as senior advisor for value-based transformation to HHS Secretary Alex Azar, co-founded palliative care provider Aspire Health in 2013.
- The Tennessean's appointment to helm the Center for Medicare and Medicaid Innovation, the office that tests alternative payment models for federally managed healthcare programs, was rumored for months. Smith replaces outgoing CMMI head Adam Boehler, who departed in the fall for a foreign economic development role in the Trump administration.
Dive Insight:
CMMI was founded with the passage of the Affordable Care Act to move the needle toward paying for quality, not quantity, in U.S. medical care. The federal government appropriated $10 billion at the agency's creation to test models over a decade, a fund Smith will manage along with some 600 employees.
CMMI, the government's main incubator for reimbursement strategies not based on fee-for-service, has broad authority to test payment systems without congressional approval. The agency traditionally enjoys bipartisan support for its cost-managing initiatives in an administration known for polarizing healthcare policies.
However, the agency has a spotty track record when it comes to model success. Of the 37 models CMMI tested by March 2018, only two were recommended for expansion, according to the Government Accountability Office.
Smith co-founded and was CEO of Aspire Health, a Nashville-based company providing home-based palliative care services to patients with complex and chronic illnesses. The Harvard graduate founded the non-hospice provider in 2013 with former Senate Majority Leader William Frist, R-Tenn., who is also a physician.
Indianapolis-based Anthem acquired Aspire in May 2018 for $440 million following an impressive period of growth for the company. The company had 200 employees in 2015 and now boasts 630, with an estimated annual revenue of $32 million, and operates in half the country.
Smith then worked as chief operating officer for Anthem's diversified business group. He has also worked for Tennessee Governor Bill Haslam and Senator Bob Corker, both Republicans.
Smith is getting some initial support from key lawmakers as well, with Senate Health, Education, Labor and Pensions committee chairman Lamar Alexander, R-Tenn., saying he has "exactly the right experience" for the post.
Smith, a former Rhodes scholar and McKinsey consultant, is replacing outgoing CMMI head Adam Boehler, who left the agency in October to lead the International Development Finance Corporation. Boehler had a hand in picking his replacement, teasing that industry would be "very happy" with the Trump administration's choice at the HLTH conference late last year.
Amy Bassano, director for CMS' bundled payments efforts, has served as acting director since Boehler’s departure.