The Centers for Medicare & Medicaid Services (CMS) is poised to enter a new era of leadership with greater independence and decision-making power, according to former agency heads who spoke at the recent National Investment Center for Seniors Housing & Care (NIC) conference. As the dust settles from the latest election, industry experts predict that CMS will have an unusually strong degree of autonomy in shaping healthcare policy—a development that could significantly impact long-term care providers.
A Skilled Team Leading CMS
Former CMS Acting Administrator Andy Slavitt and former Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, expressed confidence in the incoming leadership of CMS. Both highlighted the qualifications of CMS administrator nominee Mehmet Oz, MD, and his ability to assemble a highly skilled team.
“I do think that the people who are running CMS, it’s a really good group,” Slavitt said. “I think you’re going to see sensible people making really sensible decisions, in a very tough market. … I think this will be a team that will be open to dialogue about the sensitive issues that matter.”
Gottlieb echoed this sentiment, saying, “My view of Oz is he’s very effective, very substantive in programs. … He’s hired an exceptionally good staff. These are people who are very experienced, very good at their jobs.”
For nursing home operators and industry stakeholders, the ability of CMS to make independent decisions without excessive political interference could signal more predictable policy implementation and regulatory stability.
Potential Policy Priorities for Long-Term Care
While specific initiatives under Oz’s leadership remain uncertain, Gottlieb suggested that CMS may prioritize value-based care and capitated payment models—approaches that could reshape how skilled nursing facilities (SNFs) are reimbursed.
Value-based care initiatives have gained traction in recent years, with CMS previously launching programs like the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP). According to CMS data, the program has already led to a 1.7% improvement in hospital readmission rates among SNFs participating in the initiative. If Oz’s CMS continues along this path, nursing homes may see further shifts in payment structures that reward quality outcomes over volume-based services.
Navigating Regulatory Changes in Uncertain Times
Despite the optimism surrounding CMS’s future direction, Slavitt cautioned that economic uncertainty and potential cost-cutting measures from the Department of Government Efficiency (DOGE) could pose challenges for providers.
“The issues are in front of us that have always been in front of all of us,” he said. “It’s a very tough business. It’s very difficult to finance. We need to be creative and innovative.”
He encouraged industry professionals to remain engaged with CMS and advocate for policies that support long-term care providers and residents. “Help them make better decisions, help them change it in a good way,” Slavitt said.
As CMS gains more autonomy, the nursing home industry must prepare for potential shifts in regulations and reimbursement models. Providers should stay informed, participate in policy discussions, and be proactive in adapting to upcoming changes. With a leadership team that appears open to dialogue, the coming months may provide a crucial window for skilled nursing operators to help shape the future of long-term care policy.