Former CMMI chief Smith launching value-based care company targeting rural providers

Former Center for Medicare and Medicaid Innovation (CMMI) chief Brad Smith is using his value-based care experience to launch a new company that aims to bring those models to rural areas.

Smith, who was named director of CMMI in January 2020 under the Trump administration, launched Nashville, Tennessee-based Main Street Health alongside his venture capital firm Russell Street Ventures, which formed earlier this year.

The company will first focus in Tennessee with plans to rapidly scale up nationwide. It's initial offering, the Extra Access Program, will be available in 30 locations across eight western Tennessee counties, reaching more than 59,000 Medicare beneficiaries.

Smith told Fierce Healthcare rural providers face unique challenges in launching value-based care models that can make doing so more difficult for them.

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"You had all these models in urban, suburban [areas] … but really very little of that value-based care and those models were happening in rural areas, if at all," Smith said.

Through Extra Access, seniors treated by participating providers will be connected with a local health navigator and will be able to connect with an on-demand care team around the clock. The care team will coordinate with the patient's primary care provider, according to the announcement.

The program is backed by a proprietary patient engagement tool that will integrate electronic records from both urgent care and primary care to ensure the experience is seamless, according to the announcement.

Extra Access will also offer members same-day or next-day visits and same-day prescription refills.

Smith said rural providers are open to the additional resources that can help them implement value-based models, but connecting with them requires an individualized approach for each community.

"They’re very different communities, and what we’ve found is the biggest piece is building trust," he said.

Bennett Graham will be joining the company as its president. Graham previously served as the senior vice president of operations at Aspire Health, a palliative care company Smith also co-founded that was later acquired by Anthem.

Sarah Chouinard, M.D., will step into the role of chief medical officer at Main Street Health, according to the announcement. Chouinard previously served as CMO at Community Care of West Virginia, which operates 17 outpatient clinics and 50 school-based centers across nine counties.

The company is also backed by Oak HC/FT and Frist Cressey Ventures. Annie Lamont, managing partner at Oak HC/FT, and Bill Frist, former Senate Majority Leader and founder of Frist Cressey, will join Smith on Main Street Health's board.