The Policy Stack Seven Models in One Quarter: Making Sense of CMS's Most Aggressive Innovation Push Ever
Feb 9, 2026
Duncan Reece, a health care operator and entrepreneur who helped build value-based care organizations like Iora and Liza Health. He discusses the surge of simultaneous CMMI models and why focusing on relevant pilots matters. He talks about tech barriers, why Iora built its own EHR, and how AI and cheaper connectivity are reshaping care delivery and operational complexity.
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Unprecedented CMMI Scale
- CMMI launched seven models in one quarter, marking an unusually aggressive innovation push.
- The administration remains skeptical about whether these simultaneous experiments will deliver real savings.
Savings Need Context
- MSSP produced $2.4 billion in savings on $1.2 trillion of Medicare spending, which is a small percentage.
- Evaluating program impact requires context beyond headline savings numbers.
Early Career Shaped By Medicare Health Support
- Duncan began in value-based care before the term existed and worked on Medicare Health Support.
- That early demonstration failed and shaped his long career in many later models.
