GAO Confirms CMMI Failures, Chairman Arrington Calls for Accountability and Reform Under Trump

GAO Confirms CMMI Failures, Chairman Arrington Calls for Accountability and Reform Under Trump

WASHINGTON, D.C. - The Government Accountability Office (GAO) published a report assessing the success of the Center for Medicare and Medicaid Innovation Center (CMMI) from 2011 to 2024, in response to an April 2024 letter from House Budget Chairman Jodey Arrington (R-Texas) and then-Health Care Task Force Chairman, Rep. Michael Burgess (R-Texas).

Chairman Arrington released the following statement reacting to the GAO report:

"The Center for Medicare and Medicaid Innovation (CMMI) was created to lower health care costs and improve care-but after more than a decade, it's done neither. Instead, it has wasted billions of taxpayer dollars and implemented a paltry 4 out of the 70 models developed.

"A 5 percent success rate isn't innovation-it's failure. And with our national debt barreling past $39 trillion, we can't afford programs that promise savings but consistently come up short.

"CMMI's mission is too important to abandon, but the status quo is unacceptable. It's time for real accountability, models that actually deliver results, and a relentless focus on delivering better access and better outcomes at a lower cost.

"Under the Trump Administration's leadership, CMMI has the potential to deliver on its mission by implementing new models to lower costs and Make America Healthy Again. I'm encouraged by Secretary Kennedy's and CMS Administrator Oz's commitment to rooting out waste, fraud, and abuse and ensuring the Innovation Center finally delivers on its promise-for patients and for taxpayers."

The CMMI program was created under the Affordable Care Act (ACA) to test innovative approaches to health care problems in federal programs by both improving quality and reducing federal spending. Unfortunately, CMMI has failed to generate savings for federal health programs.

CBO determined that, from Fiscal Year 2011 to Fiscal Year 2020 CMMI had incurred a net loss of $5.4 billion, with $7.9 billion spent towards models that only yielded $2.6 billion in savings. CBO projects CMMI will continue to increase federal spending by an additional $1.3 billion in its second decade. High amounts of unobligated funds, paired with slow implementation rates, fuel the inefficiencies in the program. This is largely due to ineffective quality metrics, participation attrition issues, extended model testing period of over 2 years, and poor model design. GAO identified that the quality metrics do not effectively measure patient quality.

GAO highlights that CMMI has only a 5.7 percent success rate on models, as only 4 models of the 70 tested were successfully implemented in federal programs.