The CMS Innovation Center at 15: What worked, what didn’t, and the next big bets with Abe Sutton

Fifteen years ago Congress created the CMS Innovation Center to test new ways of delivering quality care at lower costs. Since then, the Innovation Center has tested dozens of models - some have been successes, and many have not. Director Abe Sutton joins The Other 80 for a candid conversation about the Innovation Center’s record, its next chapter, and the big bets ahead.

Abe identifies three features of successful models:

• Mandatory participation to avoid cherry picking
• Downside risk to drive provider attention and engagement
• Minimal gaps between first- and second-generation models to maintain momentum

Abe says success should not be measured by how many models work, but by overall return on investment:

“If we are taking bold bets, if we're trying to say, all right, let's back the next thing that could really transform care in a country and put the country on a more solid fiscal foundation while improving care and the affordability of care. Well, one thing that really was transformative and did that well may be worth the cost of running 20 things.”

Relevant Links

Read the CMS Accountable Communities Evaluation

Access the GAO report evaluating the CMMI model from 2011-2024

Read the CMMI’s most recent Strategic Plan

About Our Guest

Abe Sutton serves as the Director of the Center for Medicare and Medicaid Innovation and Deputy Administrator for the Centers for Medicare and Medicaid Services (CMS). Before assuming this role in January of 2025, he co-founded two health service companies; Honest Health, which focuses on enabling primary care physicians, and Evergreen Nephrology, which focuses on enabling nephrologists. Sutton focused on health policy with the federal government from 2017 to 2019, serving at the National Economic Council, Domestic Policy Council and Department of Health and Human Services. In these roles, he coordinated health policy across the federal government, with a focus on the shift to paying-for-value within Medicare, increasing choice and competition in health care markets, and updating the federal government’s approach to kidney care.

He holds a law degree from Harvard Law School and undergraduate degrees in political science, management, and health care management and policy from the Wharton School and the College at the University of Pennsylvania.

Source

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