Home-Based Care Ally Adam Boehler to Leave CMMI

A key ally for home health providers and a major proponent of value-based care may be leaving his federal post.

The Trump administration revealed late Wednesday it has nominated Adam Boehler — director of the Center for Medicare & Medicaid Innovation (CMMI) and a senior adviser to the secretary of the U.S. Department of Health and Human Services (HHS) — to lead the International Development Finance Corp. (DFC). Boehler joined CMMI in April 2018 after previously serving as CEO of in-home medical care provider Landmark Health, which he founded five years prior. 

DFC was created by the Trump administration in 2018 to oversee the distribution of U.S. foreign aid and development projects.

“You will do phenomenally at DFC,” Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma wrote in a message on Twitter. “We wish you a smooth and successful confirmation process!”

In his role at CMMI, Boehler has helped spearhead wide-ranging efforts aimed at shifting health care into the home and tying reimbursement to patient outcomes.

Most recently, those efforts included five new CMMI payment models designed to transform kidney care by encouraging greater use of home dialysis and kidney transplants for Medicare beneficiaries with end-stage renal disease.

“Americans wait three to five years, on average, for a kidney transplant,” Boehler tweeted in June. “In the meantime, thousands of people die waiting. The status quo is unacceptable, and we are committed to positive change.”

In April, CMMI — along with CMS and HHS — unveiled a new voluntary risk-based initiative designed to reward physicians who keep patients at home and away from hospitals. The initiative, formally known as the “Primary Cares Initiative,” similarly creates five new payment models that incentivize primary care providers to reduce hospital utilization and total cost of care with performance-based payment adjustments.

The Primary Cares Initiative doesn’t create new opportunities for home health providers directly, but industry insiders see a logical leap as physicians turn to home- and community-based partners.

“It can be expected that primary care practitioners in any of the five iterations of the demonstration project would embrace home health services and hospice care as vital partners in managing their patients’ care needs in the community, as well as in transition to home from an in-patient setting,” National Association for Home Care & Hospice (NAHC) President William A. Dombi previously told Home Health Care News. “We look forward to working with CMMI and primary care practitioners to achieve the goals of the project.”

Roughly two weeks before that initiative was announced, Boehler additionally hinted at the possibility of bundled payment models specifically for home health and other post-acute care providers.

In theory, bundled payments are meant to link payments for multiple services Medicare beneficiaries receive during an episode of care, thus cutting costs.

Various studies, however, have found that bundled payments achieve that goal by trimming post-acute care — with some questioning whether bundles actually lead to savings at all. 

“Now is the time to bring us ideas there. We’re really in listening mode,” Boehler said at an American Hospital Association event, referring to post-acute bundled payments. “I think there’s been a lot of intrigue and interest we’ve heard from people. So, we’re gathering stakeholder input there on that, and it’s a great time to give us thoughts on where we can lower costs.”

Since Boehler founded Landmark, the company has grown into a business with more than 1,000 employees who provide physician house calls to more than 100,000 consumers in 13 states.

Before launching Landmark, Boehler was an operating partner at $14 billion global investment firm Francisco Partners.