HIGHLIGHTS
- The Centers for Medicare & Medicaid Services (CMS) Innovation Center is testing whole-person functional and lifestyle medicine (FLM) approaches that may help prevent or manage chronic disease among Original Medicare beneficiaries.
- As the Implementation and Monitoring Contractor (IMC), Abt supports CMS in model launch, recipient onboarding, technical assistance, and monitoring and measurement of recipient progress.
- The model will help CMS build evidence on whole-person FLM approaches to improve health outcomes, quality, use, and costs.
PROJECT
Make America Healthy Again: Enhancing Lifestyle & Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) Model – Implementation and Monitoring Contract
The Challenge
Chronic disease places a significant burden on Americans and the Medicare program. In 2022, approximately 45% of Medicare beneficiaries had four or more chronic conditions, and Medicare beneficiaries with chronic conditions accounted for nearly 90% of total health care expenditures.
The CMS Innovation Center seeks stronger evidence on approaches that can help prevent illness or slow disease progression, potentially impacting millions of lives.
Through the MAHA ELEVATE Model, the CMS Innovation Center is testing FLM interventions, such as nutrition and physical activity and other services that Original Medicare does not currently cover. CMS aims to identify approaches that improve health outcomes, quality, utilization, and costs while helping patients take a more active role in their health.
The Approach
As the IMC, Abt partners with L&M Policy Research and Ames Health Strategies to support CMS throughout the model lifecycle, from launch through ongoing monitoring. Our work enables CMS to support a wide range of participating organizations and track how recipients carry out their approaches. Recipients include organizations like medical practices and health systems as well as rural clinics, senior living communities, and state or local governments.
Abt’s work spans five connected areas:
- Engagement and implementation: We engage with stakeholders, including a FLM Innovation Advisory Board, review and analyze applications, disseminate recipient communications, onboard recipients, and provide tailored technical assistance. We also help recipients strengthen their study designs and meet model requirements.
- Monitoring and analysis: We track recipient compliance with model requirements and assess their progress toward model outcomes.
- Recipient and beneficiary management: We manage recipient information, confirm beneficiary eligibility, and maintain related reports.
- Policy monitoring: We track policy and procedural changes and implications resulting from the model.
- Project management: We coordinate day-to-day work, reporting, quality checks, and planning across the contract.
The Results
As the model progresses, Abt will help CMS identify promising approaches for health promotion and chronic disease prevention. The evidence may also inform future Medicare coverage decisions or future CMS Innovation Center models.
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