The Center for Medicare and Medicaid Innovation (CMMI) is anything but innovative.  The center was created in the Patient Protection and Affordable Care Act (ACA), better known as Obamacare.  It was provided with $10 billion every 10 years beginning in 2011.  But it has been costly to taxpayers, failed to produce savings, and will continue on that path in the future.  CMMI has been so inefficient that it should be a prime opportunity for review by the Department of Government Efficiency (DOGE).

CMMI is run by the Centers for Medicare and Medicaid Services to “test new ways to deliver and pay for health care in Medicare, Medicaid, and the Children’s Health Insurance Program, with the goal of identifying approaches that reduce spending or improve the quality of care.”  Most of the pilot programs have focused on Medicare. 

A September 2023 Congressional Budget Office (CBO) report showed that CMMI had spent $7.9 billion between 2011 and 2020 and reduced spending by $2.6 billion for a net cost of $5.4 billion and between 2021 and 2030, there would be a net cost of $1.3 billion.  CBO had estimated savings of $2.8 billion from 2011-2020 when the ACA was enacted.   

Citizens Against Government Waste commented on CMMI’s lack of results and wasteful spending in blog posts on March 11, 2016  and  November 16, 2016.  Now there are new worries about how the center’s unconstrained authority is affecting Congress’s power of the purse and oversight of the executive branch, as well as patients.

At a June 13, 2024, House Energy and Commerce Committee hearing on CMMI, Committee Chair Cathy McMorris Rodgers (R-Wash.) said, “I have a hard time believing any objective observer could look at the results thus far and describe CMMI as a success.”  

Rep. Michael Burgess (R-Texas) said, “[W]hen the administration changed in 2017, and I immediately thought here is our chance to remove CMMI, the Congressional Budget Office said you can’t do that because of all these savings that are built into the law.  But then it turns out those savings were ephemeral and they weren’t really savings at all, were they?”

In December 2023, Rep. Adrian Smith (R-Neb.) introduced H.R. 6732 to increase transparency and oversight of the program.  He said, “There’s no question CMMI lacks transparency.  Worse, since its creation, it has failed to improve Medicare and Medicaid for beneficiaries — which is why I am introducing this bill to increase accountability and reassert congressional authority.”

DOGE has set its sights on wasteful spending and costly inefficient government programs and CMMI should clearly be on its list of priorities.  Innovation in healthcare is necessary to improve quality and drive down costs, but CMMI has proven it cannot achieve that objective.