12/12/2025
I want to thank Robert F. Kennedy, Jr and Dr. Mehmet Oz for advancing two initiatives that directly affect technology-enabled, outcomes-driven practices like ours.
For years, Toward Health has used digital platforms, remote monitoring, and machine-learning-supported workflows to improve outcomes in chronic disease. To do this, every clinician in our practice was required to opt out of Medicare. As a result, even after publishing outcomes data and being engaged by value-based organizations to support Medicaid and Medicare populations, we have been unable to contract directly with those patients because of our opt-out status.
This created a structural paradox: practices demonstrating improved outcomes and lower costs were effectively barred from serving the populations most in need of innovation.
The ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) and the MAHA ELEVATE program now present two potential paths forward. ACCESS offers an outcomes-aligned Medicare payment model that supports technology-enabled chronic care. MAHA ELEVATE provides cooperative agreement funding to implement and rigorously evaluate whole-person, lifestyle-based interventions that are not currently reimbursed under Medicare.
In the coming weeks, I look forward to continued engagement with U.S. Department of Health and Human Services to explore how Toward Health can support CMMI’s mission to improve outcomes while reducing costs.
For context, this model has been deployed successfully in the middle-market employer space for years, with peer-reviewed outcomes published in the medical literature:
2022: https://pubmed.ncbi.nlm.nih.gov/36144252/
2025: https://pubmed.ncbi.nlm.nih.gov/40028226/
A special thank you to Rep. Mike Lawler for convening this panel that advanced these discussions!
