Inside the Medicare innovation lab's big plans

INSIDE TRUMP'S MEDICARE INNOVATION LAB — The Obamacare-created office empowered to test radical new health care ideas has been mostly quiet under this administration, but that's about to change, POLITICO's Rachel Roubein and Dan Diamond scoop.

The Center for Medicare and Medicaid Innovation (CMMI) is planning to announce three care models this month and at least three more in early 2019, current and former staff tell POLITICO.

— Upcoming models include a pilot to redesign emergency triage, treatment and transport, which is being called "ET3"; a new approach to designing insurance plans to encourage quality, efficient care, known as "VBID 2.0"; and a new track on the existing "CPC+" program meant to strengthen primary care for patients.

— The center is now led by Trump appointee Adam Boehler, who's leaned on his entrepreneurial background and pushed staff to develop pilots at a faster pace than under the Obama administration.

He's also got fans inside HHS leadership — Secretary Alex Azar tapped him as an adviser — and among Obama-era veterans like Andy Slavitt, who calls Boehler "a person who wants to do what’s right and make progress."

— But some CMMI staff say the focus on speed is raising safety concerns. Boehler's streamlined CMMI's reliance on legal review, for instance, and staff worry that rushing out pilots could ultimately put some frail, elderly patients at risk. A bipartisan letter from House Ways and Means Committee leaders last week also raised concerns that CMMI has given Congress too little insight into its operations.

A CMS spokesperson denied that the center is reducing reliance on HHS lawyers and said that the agency is focused on safe care.