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LUGPA Policy Brief: CMS Launches Maha Elevate Model  

      AT-A-GLANCE ESSENTIALS
     

What’s Changing: The CMS Innovation Center is launching the MAHA ELEVATE model to test evidence-based lifestyle and functional medicine interventions for Original Medicare beneficiaries.

Why It Matters: The model will generate cost and quality data that could inform future Medicare payment and coverage decisions for whole-person, preventive approaches.

Who Can Participate: Provider organizations, ACOs, health systems, and community-based partners. Urology practices may participate directly or through partnerships.

Key Dates: Notices of Funding Opportunity (NOFO) expected in early 2026; first cohort begins September 1, 2026; second cohort begins in 2027.

January 2026 

Overview

The CMS Innovation Center has announced the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) model. This initiative will test and fund evidence-based lifestyle and functional medicine interventions for Medicare beneficiaries, to evaluate clinical outcomes, utilization, and total cost of care to inform potential future Medicare payment and coverage pathways.

Key Features

  • Funding: Approximately $100 million total
  • Awards: Up to 30 cooperative agreements
  • Duration: Three years per award
  • Timeline:
    • NOFO expected in early 2026
    • First cohort begins September 1, 2026
    • Second cohort begins in 2027
  • Eligible Interventions: Evidence-based lifestyle or functional medicine programs that complement conventional care
    • Required components: Nutrition and/or physical activity
    • Optional components: Sleep, stress management, substance avoidance, social connection, and psychological health
  • Special Focus: At least three awards reserved for dementia prevention and management interventions
  • Evaluation Goals: Assess impacts on clinical outcomes, healthcare utilization, and total cost of care

Relevance to Urology Practices

Many Medicare patients treated in urology practices—particularly those with cancer and other chronic conditions, present with comorbidities influenced by modifiable lifestyle factors. CMS has cited the high prevalence of chronic disease among Medicare beneficiaries as a key rationale for testing preventive and whole-person care models.

Some urology practices already coordinate or refer patients to services such as nutrition counseling, exercise programs, pelvic floor rehabilitation, stress management, and behavioral health support. These services are generally not reimbursed under traditional Medicare. MAHA ELEVATE provides a CMS-sponsored framework to formally evaluate these interventions and their impact on patient outcomes and costs.

For practices participating in ACOs, MIPS, or other value-based care arrangements, lifestyle interventions may align with existing quality and utilization objectives. Participation in these programs is not required to engage with the MAHA ELEVATE model.

Implementation Considerations

  • Practices may participate independently or through partnerships with ACOs, health systems, or community-based organizations
  • Multidisciplinary teams may be necessary to meet intervention design, data collection, and reporting requirements
  • Additional participation details, selection criteria, and reporting standards will be released in the NOFO

Conclusion

The MAHA ELEVATE model represents a new CMS Innovation Center effort to test lifestyle and functional medicine interventions in Medicare. For urology practices, the model may be most relevant where lifestyle-oriented services are already offered or coordinated and where practices have the capacity to engage in CMS-sponsored evaluations that could shape future Medicare payment and coverage policy.