- Elizabeth Fowler will be the new director of CMS' innovation center, per the HHS directory, confirming weeks of speculation the health policy expert and Obama administration alum would be taking on the role.
- As head of the Center for Medicare and Medicaid Innovation, Fowler will direct federal government efforts and run payment models in a bid to inject value into the U.S. healthcare system.
- Fowler has previously held leadership roles at HHS and helped draft and implement the Affordable Care Act, the law underpinning much of President Joe Biden's health policy agenda. She later worked as a VP for global health policy at pharma giant Johnson & Johnson.
CMMI was founded a decade ago with the passage of the ACA, with an aim to move the needle toward paying for quality, instead of quantity, of care in the U.S. healthcare system. The government appropriated $10 billion to test novel payment models at the agency's creation, a fund Fowler will now oversee along with roughly 600 employees.
Fowler, whose appointment was speculated for weeks but only recently popped up in the HHS directory, has a long background in health policy. During the Obama administration, Fowler was a special assistant on healthcare and eocnomic policy at the National Economic Council, along with deputy director of policy in CMS' Consumer Information and Insurance Oversight Office.
Fowler was also chief health counsel to former Senate Finance Committee Chairman Max Baucus, D-Mont., where she helped write the ACA.
Since leaving federal government, Fowler has worked as VP for global health policy at pharma giant Johnson & Johnson, and most recently served as EVP for programs at the nonprofit Commonwealth Fund.
Fowler is replacing Brad Smith, who held the reins at CMMI for a little over a year at the tail end of the Trump administration. CMMI generally enjoys bipartisan support, but has faced criticism in recent years for its broad authority to test sweeping payment systems without congressional approval.
The agency has a spotty track record when it comes to model success. Of the 37 models it had tested by early 2018, only two were recommended for nationwide expansion, according to the Government Accountability Office. Over the past decade, CMMI has tested 54 models, yet just five have saved significant amounts of money and only two have expanded nationally, Smith said in September.
A bipartisan group of legislators introduced a bill in the House about one year ago to give Congress broader oversight of CMMI's activities by creating guardrails against policy changes made unilaterally by a single administration, while increasing transparency and public participation.
But proponents of the innovation hub note its work is ever more important as U.S. healthcare costs skyrocket and Medicare faces looming insolvency. According to the Congressional Budget Office, the trust fund that finances Medicare's hospital benefit will run dry by 2024 without meaningful action to curb spending.