Make America Healthy Again – Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence

Posted by Center for Medicare and Medicaid Services

Description

The Centers for Medicare & Medicaid Services (CMS), through its Centers for Medicare and Medicaid Innovation (CMMI or Innovation Center), is soliciting applications for the Make America Healthy Again: Enhancing Lifestyle & Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) Model. This voluntary, three-year service delivery model is designed to test evidence-based, whole-person functional or lifestyle medicine (“whole-person FLM”) approaches to care. Rather than treating diseases separately after they develop, MAHA ELEVATE takes a proactive, comprehensive approach that combines psychological, nutritional, and physical interventions with personalized, lifestyle-based strategies for prevention and early treatment. Throughout this NOFO, we use the term “whole-person FLM” to represent a range of services or approaches often incorporated in lifestyle and functional medicine that are not currently covered under Medicare. It is important to clarify that CMS is not establishing a new industry standard through the use of this terminology. The term “whole-person FLM” as used in this NOFO does not represent an attempt by CMS to create, define, or establish any new industry-wide standard, practice guideline(s), or healthcare delivery model beyond the scope of this specific Innovation Center model and funding opportunity. Similarly, through this funding opportunity, CMS is not creating a new category of covered services for Medicare purposes. This term serves solely as a descriptive reference within this document to facilitate clear communication about the non-covered services being tested in this model and should not be interpreted as having any regulatory, coverage, or policy implications beyond the context of this specific Innovation Center model.CMS will select a total of up to 30 Recipients to participate in MAHA ELEVATE. The model will be split into two cohorts, one year apart (years 2026 and 2027). CMS will select recipients based on five key criteria: • Whole-person FLM intervention design, including cost savings. • Beneficiary recruitment and study design. • Organizational and administrative capacity. • Data management capabilities. • Budget. Highly competitive applicants must demonstrate several important strengths: • Strong, evidence-based support for your proposed intervention(s) and proof of your own successful history of implementation of the intervention and cost savings. • Ability to recruit large numbers of participants with a clear randomization plan and advanced data management capabilities. Given the model’s minimum beneficiary targets and extensive data management requirements, applicants who do not directly provide clinical care are strongly encouraged to form partnerships with care entities or organizations that deliver clinical care. This collaboration helps ensure you can meet the full operational requirements of the program.

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