Over the last month and a half, HHS and CMS have released a good deal of information that provides insight into what we can expect to see in priorities and programming over time. Though each released document focuses on a slice of the CMS and HHS portfolios, four key overarching themes look to be woven throughout:
- Unleashing Technology
- Ensuring Shared Risk and Skin in the Game
- Prioritizing Financial Stewardship, and
- Being Open to New Ideas and Change
Let’s take a look at each of released documents with an eye toward impacts on primary care and population health.
1. New CMS Innovation Center Strategy
The new CMS Innovation Center (or Center for Medicare and Medicaid Innovation, CMMI) white paper and accompanying FAQ were released on May 13, 2025. They focus on three central pillars:
a. Promoting evidence-based prevention
All three levels (primary, secondary, and tertiary) of prevention are addressed with an openness to community-based initiatives. There is a lot for primary care and population health to like about this focus, particularly the idea of new ways to support the initiation and maintenance of constructive lifestyle changes (e.g., exercise, nutrition, etc.) including the potential for beneficiary incentives, and partnering with community-based organizations. The success of Accountable Care Organizations (particularly those led by primary care physicians) in moderating cost, attending to prevention, and producing outcomes is worth reflecting upon here.
b. Empowering people to achieve their health goals
This includes helping people get user-friendly information that is easily available when they need it, as well as encouraging people to partner in their care and make informed decisions that are right for them. In addition to increasing patient access to data and to comparative provider performance, the white paper specifically lists the examples of mobile devices, apps shared decision-making tools, and health education materials.
c. Driving choice and competition for people
As a health system become more consolidated and purchase or merge with smaller systems and/or purchases primary and specialty care practices, they are able to exercise increased negotiating power (https://www.rand.org/pubs/research_reports/RRA1820-1.html ). In addition, when primary care practices are acquired and provided in hospital outpatient facilities, a separate fee can be charged in addition to the underlying service. Commercial insurers and patients feel the cost increases, and so does CMS. Bolstering independent practice provides a counterweight to the increase in consolidation and may be helpful in ensuring that beneficiaries and patients who live in rural and underserved locations have access to care as well. In addition,
New models will be built with a concerted aim to, when completed, be able to satisfy the actuarial requirement for certification. Thus, that an idea will achieve cost savings will be key. To reduce the selection bias and catalyze change, it is possible that the Center may require participation for some endeavors.
2. New Report on Childhood Chronic Disease
The Make America Healthy Again (MAHA) Report on Childhood Chronic Disease was originally issued on May 22, 2025 and pulled back by Administration, but reissued shortly afterward in its current form. The reissued document corrects some citation and study reference issues in the original report. The report is a product of a Presidential Commission to focus on building a healthier America and an accompanying strategy is expected to be released in mid-August.
The report focuses on the higher-than-desirable percent of children with chronic disease and points to four major contributing factors: 1) poor diet, 2) exposure to environmental toxins, 3) lack of physical activity and chronic stress, and 4) overmedicalization. Even with the corrected citations, the report remains somewhat controversial in some of its claims, especially in light of the substantial literature supporting vaccine safety.
However, many recommendations resound across a wide variety of audiences, including:
- Requiring nutrition courses in medical school curriculums;
- The influence of corporate interests in policy setting; and
- The need to increased attention and interventions to address the issues of nutrition, lifestyle, and exposure to pollution and harmful chemicals.
3. CMS National Quality Strategy
Early June was a busy time for health technology and information policy at the federal level. With the recent appointment on June 3rd of Dr. Thomas Keane as Assistant Secretary for Technology Policy (ASTP) and National Coordinator of Health Information Technology, the stage is set for additional policy to be announced. He comes with experience at the federal level and a background as both a physician and a software engineer. As Dr. Keane steps into his role, the agency is reviewing a host of submissions to a Request for Information (RFI) on the Health Technology Ecosystem that was issued in May.
The same day that Dr. Keane’s appointment was announced, so were several initiatives including:
- Building a dynamic, interoperable national provider directory;
- Bringing modern identity verification processes to Medicare.gov to streamline credentials across the healthcare system;
- Expanding functionality of CMS’ Blue Button 2.0 patient access application programming interface (API);
- Transitioning CMS’s Data at the Point of Care pilot to general availability; and
- Enhancing CMS’ participation in trusted data exchange
The CMS National Quality Strategy is evolving, and we anticipate additional information about direction to come out soon. This said, reduction of administrative burden in the collection of data and improving the sophistication of analysis as well as increasing the usefulness of reporting will continue to be important. Importantly, the Universal Foundation, a set of streamlined adult and pediatric measures, has been echoed identified as being key to a healthier America, as have Meaningful Measures 2.0
We also anticipate high priority on moving to digital quality measures and an increased focus on person-reported outcome performance measures. In addition, there is likely to be a continuing focus on:
- Outcomes and Alignment
- Access for All and Engagement
- Safety and Resiliency
- Interoperability and Scientific Advancement
Michigan Multipayer Initiatives 