forbes.com
CMMI's Failure: \$5 Billion Overspend, Unchecked Power
The Center for Medicare and Medicaid Innovation (CMMI) has increased net federal spending by over \$5 billion in its first decade, failing to meet its goals and overstepping its authority; its projected \$1.3 billion spending increase over 2021-2030 makes its elimination a fiscally responsible and necessary step.
- How has CMMI overstepped its original mandate, and what specific examples demonstrate its abuse of power?
- CMMI's failures stem from both its underperformance and its overreach. While many government agencies underdeliver, CMMI's attempts to unilaterally impose nationwide payment models on healthcare providers and patients without Congressional oversight represents a significant abuse of power. This is exemplified by a 2016 proposal to drastically alter Medicare Part B reimbursement, which was thankfully abandoned.
- What are the key failings of the Center for Medicare and Medicaid Innovation (CMMI), and what is their immediate financial impact?
- The Center for Medicare and Medicaid Innovation (CMMI) has consistently failed to meet its goals of reducing taxpayer spending and improving care quality, instead increasing the financial burden by over \$5 billion in its first decade. Four out of 49 payment models (8%) met expansion criteria, while four models were recently discontinued due to cost overruns and poor performance, saving \$750 million.
- What are the long-term implications of maintaining CMMI, and what reforms are needed to prevent future instances of bureaucratic overreach?
- The continued existence of CMMI poses a significant threat to fiscal responsibility and democratic governance. Eliminating its \$1.3 billion projected spending increase over the next decade would provide fiscal relief and curb the agency's unchecked expansion of power. Future reforms should prioritize Congressional oversight to prevent similar situations.
Cognitive Concepts
Framing Bias
The headline and opening sentences immediately frame CMMI negatively, setting a critical tone. The article consistently emphasizes negative financial impacts and failures, while downplaying or omitting any potential positive aspects. The concluding sentence explicitly calls for Republicans to 'deprive the left' of CMMI, further reinforcing a partisan framing.
Language Bias
The article uses loaded language such as "failed to deliver," "increased financial burden," "worst experiments," and "power grabs." These phrases carry negative connotations and lack neutrality. More neutral alternatives could include "has not met expectations," "increased costs," "initiatives with mixed results," and "expanded its authority." The repeated use of terms like "failed" and "disappointing" reinforces a negative narrative.
Bias by Omission
The article omits perspectives from CMMI supporters or those who believe its initiatives have had positive impacts. It focuses heavily on criticisms and negative financial outcomes, neglecting any potential benefits or successes, however limited. The lack of counterarguments weakens the analysis and presents a one-sided view.
False Dichotomy
The article presents a false dichotomy by framing the issue as either supporting CMMI or accepting major healthcare reforms through Congress. It ignores the possibility of alternative approaches to reforming Medicare and Medicaid that don't involve CMMI or solely rely on Congressional action.
Sustainable Development Goals
The article highlights CMMI's failure to improve patient outcomes despite significant financial investment. Multiple payment models failed to meet their own criteria for expansion, and a review of the Primary Care First Model showed "limited evidence the reported changes in care delivery have improved outcomes". This negatively impacts the SDG target of ensuring healthy lives and promoting well-being for all at all ages.