CMMI Seeks Lifestyle Interventions That Enhance Health Outcomes Underneath New Model | Jones Day

The Center for Medicare & Medicaid Services Innovation (“CMMI”) introduced the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-Based Approaches Through Evidence (“MAHA ELEVATE”) Model, designed to enhance well being outcomes for authentic Medicare beneficiaries (i.e., price for service, non-Medicare Advantage beneficiaries) via evidence-based prevention and whole-person care.

As mentioned in additional element in our three-part series, since May 13, 2025, CMMI has been developing a brand new framework for value-based care that empowers individuals to drive their very own well being objectives and mitigate continual ailments, together with its latest collaboration with the Food and Drug Administration (“FDA”) on a pilot program that allows digital well being units with out FDA premarket authorization to offer care beneath a CMMI program. As a part of this plan, on December 11, 2025, CMMI announced the MAHA ELEVATE Model that evaluates the associated fee and high quality of evidence-based whole-person care on the unique Medicare inhabitants.

The mannequin will fund as much as 30 cooperative agreements, with a complete funds of roughly $100 million over a three-year efficiency interval to gather high quality and price information on whole-person purposeful or life-style drugs interventions that complement or increase—however don’t change—typical drugs. All proposed interventions should: (i) not already be coated by authentic Medicare; (ii) have documented proof of efficacy; and (iii) incorporate diet or bodily exercise as a part of its design. Three awards can be reserved for interventions that tackle dementia.

Eligible organizations embody, however are usually not restricted to:

• Private medical practices;
• Health techniques;
• Accountable care organizations;
• Academic organizations;
• Functional, life-style, preventive, and integrative drugs facilities;
• Federally Qualified Health Centers and Rural Health Clinics;
• Community-based organizations;
• State or native governments;
• Indian Health Service/Tribal Services/Urban Indian Health Programs; and
• Senior residing communities.

To be chosen, candidates should reveal that they—or their companions—have expertise delivering the proposed interventions and that the interventions are protected, efficient, and supported by peer-reviewed literature. Applicants should additionally present expertise with information assortment, or a reputable means to gather and report correct information in a well timed method, with acceptable beneficiary safeguards.

Cooperative agreements can be awarded in two rounds for 2 separate cohorts—one beginning in 2026 and the second in 2027. CMMI will launch a Notice of Funding Opportunity in early 2026 for the primary cohort, and the mannequin will launch on September 1, 2026.