“We’re excited by the prospect of this more holistic approach,” said Ann Greiner, president and CEO of the Primary Care Collaborative.
“CMS is finally providing the ‘fuel’ — funding for nutrition, stress management, and wearables — but if we pour this high-octane fuel into the existing ‘broken engine’ of episodic, brick-and-mortar care, it won’t work,” said Sean Mehra, co-founder and CEO of virtual primary care company HealthTap.
It’s a “long overdue push from CMS to get out of solely sick care to focusing on payments for prevention,” said Dr. Sanjay Doddamani, founder and CEO of Guidehealth.
These were the reactions to the December announcement from the Centers for Medicare and Medicaid Services regarding its MAHA ELEVATE (Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence) model. Through it, the government will invest about $100 million in three-year cooperative agreements supporting up to 30 projects focused on health and prevention for traditional Medicare beneficiaries.
These proposals will focus on “whole-person care approaches” like functional and lifestyle medicine, including nutrition and physical activity that are currently not covered by traditional Medicare.
“For decades, health policy has focused too much on flashy, expensive surgeries and too little on the unglamorous work of prevention. … MAHA ELEVATE is a first-of-its-kind initiative to test evidence-based approaches that treat the root causes of health problems before they turn into emergencies. … 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,” said Abe Sutton, director of the Center for Medicare and Medicaid Innovation, in a statement.
Several experts say the model addresses a long-standing gap.
Greiner of the Primary Care Collaborative (PCC) said the ELEVATE approach is about giving the people what they want.
“There’s a lot of seeking of ‘alternative approaches’ to keeping yourself healthy or restoring yourself to health that aren’t necessarily in the traditional milieu,” she said.
To at least one healthcare executive, however, the ELEVATE program is “directionally right” but difficult to implement effectively.
“You simply cannot build the trust required to change a lifetime of habits in a rushed 15-minute visit once a year. The impact will depend entirely on whether we use this funding to build a new delivery chassis based on high-frequency, low-friction virtual primary care,” said Mehra of HealthTap.
What is the program?
The ELEVATE program is the first Innovation Center model that focuses on “proactive, holistic, patient-centered functional or lifestyle medicine approaches to support conventional care.” Key areas include nutrition, physical activity, sleep, stress management, avoiding harmful substances and social connection.
Recipients of the funding will be organizations that provide whole-person functional or lifestyle medicine services or partner with organizations that provide these services. They could include private medical practices, health systems, accountable care organizations, academic organizations and community-based organizations. All proposals have to include nutrition or physical activity, and three awards will be focused interventions for dementia.
“To be selected, applicants must demonstrate that they — or their partners — are experienced in delivering these interventions and that the interventions are safe and effective for the target population and supported by peer-reviewed literature,” the announcement states. “Additionally, they must demonstrate experience with data collection or the ability to accurately collect and report data in a timely manner, with appropriate beneficiary safeguards.”
The ELEVATE program has three main goals:
- Build evidence: Generate cost and quality data on the effectiveness of whole-person, lifestyle-focused care in Original Medicare
- Empower patients: Help people take control of their health through nutrition, physical activity and mental wellness interventions
- Promote wellness: Prevent illness and slow or reverse disease by supporting behavior changes that improve overall health
CMS will release a Notice of Funding Opportunity in early 2026 that will explain how organizations can apply to the ELEVATE model. The agreements will be awarded in two rounds for two cohorts, the first starting in 2026 and the second in 2027.
What industry leaders are saying
Doddamani of Guidehealth believes the impact of the model will largely depend on the evidence it can build.
“If CMS can show that things like working with a nutritional coach, participating in tai chi classes for balance and blood pressure control, or structured lifestyle programs actually improve outcomes and lower total cost, that changes the conversation about what Medicare should pay for. The real value is that it moves prevention from philosophy to data to payment,” he said.
Greiner of the Primary Care Collaborative is particularly excited about what the ELEVATE model means for primary care, noting that less than 1% of NIH funding goes to primary care.
“We want primary care to do so much, and we keep asking primary care to do more and more, but we pay primary care less than five cents on the dollar. We have a misaligned system in many ways. And so I think what this represents is the potential of testing some of these new models that may have some evidence,” she said.
She added that for this program to be successful, there needs to be a lot of transparency on the evidence supporting the selected innovations for the program and a rigorous process for evaluating their effectiveness. The same rigor that is applied to drug testing should be applied in the ELEVATE model as well.
Another health executive argued that the model’s success will depend on its ability to engage and retain patients.
“If these interventions are treated as separate ‘programs’ rather than tools in a doctor’s bag, they will fail,” said Dr. Geoffrey Rutledge, co-founder and chief medical officer of HealthTap. “The primary care doctor must be the ‘chief coach,’ using these new funded tools to guide the patient. … A significant weakness of the model as described is that it risks being an ‘adjunct’ to primary care rather than the core of it. Lifestyle medicine shouldn’t be a referral; it should be the foundation.”
He added that the model will be most effective by using mobile apps to simplify connections with primary care doctors and by integrating wearable devices, such as Oura rings or continuous glucose monitors, to provide actionable health guidance.
Ultimately, lifestyle needs to stop being treated as a “side dish,” according to Rutledge’s colleague.
“It must be the main course, served digitally,” Mehra of HealthTap said. “The future of chronic disease management isn’t a better pill; it’s a better relationship. We need to fund the infrastructure of influence — mobile-first platforms that turn a doctor from a distant authority figure into a daily partner in health.”
This may flip the narrative on the U.S. healthcare system, which is often described as a “sick care model,” meaning it primarily treats people after they’ve become sick or injured, thereby contributing to higher costs, as opposed to a healthcare model, which prioritizes prevention through early screening and other tools.
In fact, about 90% of the nation’s roughly $4.9 trillion in annual healthcare spending is for people with chronic and mental health conditions, many of which are preventable or better managed with earlier intervention, according to the Centers for Disease Control and Prevention.
Photo: Halfpoint Images, Getty Images
