The Centers for Medicare & Medicaid Services (CMS) in Woodlawn, Maryland, recently unveiled a new strategic direction for the agency in 2025. The focus of this updated strategy, titled “Making America Healthy Again,” emphasizes prevention, choice, competition, and accountability in the healthcare delivery system. This shift aligns with the principles of transparency, accountability, prevention, and competition that have been advocated for in the healthcare industry for over 30 years.
The new CMS strategy acknowledges the structural flaws in the fee-for-service model and aims to promote evidence-based prevention, patient empowerment, and competition. It also highlights the importance of provider accountability and ties model success to both outcomes and cost, marking a departure from previous approaches.
To truly deliver value for the American taxpayer and patient, it is crucial to view this new strategy as a first step rather than a final solution. The current healthcare delivery model is fundamentally broken, and incremental changes will not address the systemic misalignment of incentives that drive poor performance. A new business model for care delivery is needed, one that prioritizes health outcomes and defines success in terms of value created rather than services billed.
CMS must avoid being overly prescriptive and instead set expectations for providers to innovate and compete based on performance. The emphasis on accountability across the continuum of care is a significant shift, aiming to incentivize care delivery in settings that make the most clinical and economic sense rather than those that generate the most revenue.
Site-neutral payment is a necessary correction to remove perverse incentives and encourage providers to rethink how and where care is delivered. The purpose of public reimbursement is to deliver value for patients and taxpayers, not sustain the financial model of any one stakeholder.
The CMS Innovation Center’s new strategy is a step in the right direction, focusing on fiscal soundness and outcome improvement in every model. Accountability must extend to every part of the delivery system, with transparent reporting of outcomes, real downside risk for underperformance, and support for high-performing independent providers.
Moving forward, translating this vision into operational reality will require disciplined execution, clarity of vision, clearly defined milestones, and a relentless focus on results. CMS should create conditions for innovation, enforce transparency and accountability, and let market forces reward high performance.
The 2025 strategy from the CMS Innovation Center signals a promising shift in direction, but success will depend on aligning incentives, enforcing accountability, supporting competition, and educating both providers and patients in a truly value-based marketplace. While there is still work to be done, this new strategy provides a starting point for positive change in the healthcare industry.
