Tennessee Entrepreneur to Head HHS Office on Value-Based Care

Brad Smith, co-founder of palliative care provider Aspire Health, is the new head of the Department of Health and Human Services’ health innovation center, the agency announced Jan. 6.

Smith will head HHS’s Center for Medicare and Medicaid Innovation (CMMI) and will be charged with carrying out the Trump administration’s efforts to send taxpayer dollars toward paying for patient outcomes rather than individual procedures. Smith will also serve as senior adviser to the secretary for value-based transformation and innovation.

The CMMI has expansive authority to create and test health-care payment systems without congressional approval. As health costs continue to rise, both industry participants and regulators acknowledge they need to find ways to provide quality care while staying financially viable. New payment models are designed to pay doctors more for taking better care of patients and managing the cost.

Smith started Aspire with former Senate Majority Leader Bill Frist (R-Tenn.), who is also a physician, in 2013. He told the nonprofit Coalition to Transform Advanced Care that he became interested in the holistic treatment of serious illnesses after watching his grandmother go through a series of hospitalizations, a nursing home stay, and “lots of discomfort” before she died.

Smith had no experience in health care when he and Frist started Aspire, but he picked it up quickly, Frist said in an interview. He got support from doctors and insurers and took the idea to 25 states before selling the company. Aspire’s work is an example of the sort of programs CMMI should be pursuing, Frist added.

Smith sold Aspire to Anthem for an estimated $440 million in 2018. Before launching the company, he was chief of staff at the Tennessee Department of Economic Development. He also was a consultant at McKinsey & Company and served as a staffer for former Sen. Bob Corker (R-Tenn).

Unanimous Decision

Adam Boehler, the innovation center’s previous director, left the office Oct. 1 after he was confirmed to lead the International Development Finance Corp. Amy Bassano has served as acting director since Boehler’s departure.

Boehler helped choose his successor. He said in an interview that he felt it was important to find someone who would put their own mark on the innovation center and go beyond his efforts.

Choosing Smith as the new director was a unanimous, noncontroversial decision for HHS Secretary Alez Azar, Boehler, and Centers for Medicare & Medicaid Services Administrator Seema Verma. They looked at a variety of candidates, but Smith was the “hands-down winner,” Boehler said.

“Many of the innovations taking place are happening around the states,” former CMS Administrator and FDA Commissioner Mark McClellan said in an interview. Smith’s experience working in state government will help him in pushing for changes in health arenas other than Medicare.

Over the past two years, the innovation center has introduced 17 payment models on everything from the care of mothers with opioid use disorder to emergency transportation services to facilities other than hospitals. Smith would be tasked with finishing those models and getting health-care providers to participate in them.