President Joe Biden has chosen Obama administration veteran Liz Fowler to lead the Center for Medicare and Medicaid Innovation (CMMI), which has authority to shape key payment models, according to a report in Politico.
Fowler is the latest Obama administration veteran to be reportedly chosen by Biden to oversee his healthcare agenda. He has reportedly chosen Chiquita Brooks-Lasure, another Obama veteran, to lead the Centers for Medicare & Medicaid Services (CMS).
Fowler most recently joined the Commonwealth Fund in 2019 as the executive vice president for programs.
Before joining the nonprofit, she served as the special assistant to former President Barack Obama on healthcare and economic policy with the National Economic Council. She also assisted with implementation of the Affordable Care Act (ACA) while at the Department of Health and Human Services (HHS).
She also was the chief health counsel for former Montana Sen. Max Baucus, who served a key role in drafting and pushing the ACA through Congress as chairman of the Senate Finance Committee.
The administrator of CMMI, which was created under the ACA, does not require congressional confirmation like appointees to CMS or HHS do.
Fowler would be in charge of implementing and managing payment and value-based care models.
It remains unclear how the Biden administration will approach payment models or how it could differ from the Trump White House.
Former CMS Administrator Seema Verma had criticized whether payment models developed during the Obama administration generated enough value and savings for Medicare. She said last fall that a review of the models showed “very little return on investment.”
She said a review of the center’s initiatives found bundled payment models, which give providers a bundled amount for the total cost of care, had mixed results in terms of savings. She did praise models that called for providers to take on risk at a faster pace.
Brad Smith, the former head of CMMI, said last September that a review of the agency’s payment models found ones that used a global budget produced the most savings. He gave the example of Maryland’s Total Cost of Care model that sets a per capita cap on state Medicare costs.
Fowler has criticized some of the models created under the Trump administration.
Late last year, she co-wrote a blog for the Commonwealth Fund with major questions over the Medicare Geographic Contracting model that would enroll beneficiaries in a managed-care-like plan. In the model, accountable care organizations, health systems, physician groups and health insurance plans will take on the full financial risk for caring for Medicare fee-for-service beneficiaries.
One of the questions the blog asked is whether the quality of care will be evaluated by surveying beneficiaries and measuring outcomes, similar to the Medicare Advantage star ratings system.
“Will these data be sufficient to evaluate care for frail and vulnerable beneficiaries?” the blog post asked.