Friday, February 5, 2021 On January 13, 2021, Brad Smith, the fourth director of the Center for Medicare and Medicaid Innovation (the “ Center”), published an article[1] in the New England Journal of Medicine in which he evaluates the Center’s performance over its decade-long history against the Center’s stated goals – to decrease health care spending and improve health care quality. Smith describes an underwhelming showing from the Center and puts forward several key lessons from the Center’s past performance as a way to inform and improve future performance. Ten Years With Very Little to Show Over the past ten years, the Center has used $20 billion to launch 54 payment models – all payment models targeting various areas of the health care sector with almost 1 million participating health care providers and approximately 26 million covered patients. Despite this financial outlay and scope, most of the Center’s models have operated at a net loss without realizing any savings for the Medicare and Medicaid programs. Some of these poor-performing models are on track to realize billions of dollars in losses over the course of their respective testing periods.