CMS unveils new model aimed at functional, lifestyle medicine

The Trump administration has unveiled a new payment model that could extend Medicare coverage to functional or lifestyle medicine providers.

Under the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence, or MAHA ELEVATE, model, the Centers for Medicare & Medicaid Services (CMS) will make $100 million available to support as many as 30 proposals to promote health and preventive care in three-year agreements.

The CMS said on the landing page for the model that it’s meant to offer additional options to beneficiaries without replacing their medical services.

Abe Sutton, director of the the Center for Medicare and Medicaid Innovation, said in an accompanying video that the ultimate goal is to “empower people with Medicare to lead healthier lives” by addressing factors like nutrition, physical activity, sleep and stress.

“These programs will support innovative care that works alongside conventional medicine to prevent disease and improve quality of life without any added cost to people,” Sutton said.

The CMS said it will launch the initial notice of funding opportunity for the model in early 2026 to secure the first group of participants, with the full launch set for September.

The agency added that the programs tested under the MAHA ELEVATE model will help inform future coverage determinations and offer critical feedback the CMMI can use to build future models.

The CMS unveiled MAHA ELEVATE shortly after the announcement of its new ACCESS model, which aims to encourage the use of technology in care for Medicare patients. The model has been positively received by health tech companies that have traditionally struggled with Medicare coverage.

The National Association of ACOs said it welcomes the new model in a statement.

“The funded proposals will help build the evidence base for preventive and integrative care strategies that are not currently covered under traditional Medicare,” NAACOs said.

“Currently, many accountable care organizations use shared savings to provide patients interventions that are shown to help prevent or improve chronic conditions,” the organization said. “These include physical activity and nutrition programs. We expect ACOs will be interested in pursuing this opportunity to build on their local efforts to help advance preventive and integrative care strategies that could shape future Medicare payment policies.”

The Primary Care Collaborative offered similar support for the model.

“For decades, the American health system has prioritized incenting services rather than incenting health,” said Ann Greiner, President and CEO of the PCC. “This announcement reflects a growing awareness that our current approach doesn’t work. We’re grateful that the Innovation Center is committed to a model that prioritizes capturing data for evidence-based interventions that support prevention, health promotion and chronic care management to shift our system to more holistic care.”