LUGPA Policy Brief – CMS Innovation Center’s Strategy for a Healthier Future

May 2025 

The U.S. healthcare system continues to face major challenges: rising costs, increasing rates of chronic disease, and lagging health outcomes compared to peer nations. In response, the CMS Innovation Center has released a renewed strategy focused on prevention, patient empowerment, and fostering competition within care delivery systems. These efforts aim to improve population health, ensure better value for taxpayer dollars, and support a more sustainable health system.

The Need for Reform

Healthcare spending continues to grow faster than the economy, while the Medicare Hospital Insurance Trust Fund faces projected insolvency by 2036. States are also struggling with rising Medicaid costs. At the same time, chronic disease affects 60% of Americans and is a major driver of both cost and poor outcomes.

The Innovation Center’s Updated Strategy

The Center’s new framework emphasizes three areas:

• Evidence-Based Prevention: All new models will include prevention strategies, with expanded access to programs like the Medicare Diabetes Prevention Program. Focus areas include promoting healthy behaviors, chronic disease risk reduction, and measuring outcomes to ensure effectiveness.
• Patient Empowerment: Patients will gain greater access to digital tools, provider quality data, and cost transparency to support informed decision-making. CMS is also exploring predictable cost-sharing options to improve access to essential services.
• Choice and Competition: New models will reduce administrative burdens and encourage participation from a broader range of providers, including independent practices. This shift supports innovation and gives patients more care options.

Implications for Urology and Independent Practice

LUGPA supports the Innovation Center’s move toward preventive, patient-centered care. These reforms align with our long-standing advocacy for value-based models that support independent, physician-led practices. It is essential that these efforts remain voluntary, adequately funded, and flexible enough to accommodate the diversity of today’s practice settings.

The CMS Innovation Center’s updated strategy represents a meaningful step toward a more proactive and sustainable healthcare system. With a focus on prevention, patient choice, and innovation, this approach can potentially improve outcomes and reduce costs. LUGPA will continue to advocate for policies that preserve access, strengthen independent practices, and improve specialty care delivery.