CMS Elevate Explained: A Primer on the MAHA ELEVATE Model

CMS Elevate Explained: A Primer on the MAHA ELEVATE Model

The landscape of American healthcare is shifting from a reactive sick-care system to a proactive wellness model. Central to this transformation is the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) Model. Announced by CMS, this initiative represents a bold step toward addressing the chronic disease epidemic by funding interventions that target root causes rather than just symptoms.

For payers and healthcare decision-makers, understanding the CMS Elevate guidelines is essential for staying ahead of value-based care trends.

What is CMS Elevate?

The MAHA Elevate Model is a voluntary initiative providing approximately $100 million in funding to evaluate whole-person care approaches for Original Medicare beneficiaries. Launched under the guidance of HHS, the model focuses on functional and lifestyle medicine interventions—such as nutrition, physical activity, sleep, and stress management—that are currently not covered by standard Medicare.

The goal is to build a robust U.S. evidence base of cost and quality data to determine which lifestyle interventions effectively slow or reverse chronic disease progression and, ultimately, help inform future coverage and quality metrics. 

Key Things to Know About the MAHA Elevate Model

• Whole-Person Focus: Every proposal must include a nutrition or physical activity component. This aligns with the "food as medicine" movement, emphasizing that dietary choices are primary drivers of health outcomes.
• Targeting Chronic Disease: Currently, 6 in 10 Americans live with at least one chronic disease. CMS Elevate aims to reduce the 90% of healthcare spending currently attributed to these conditions.
• Voluntary and Complementary: These interventions are designed to support, not replace, conventional medical care. Beneficiaries maintain all their standard Medicare rights and protections.
• Timeline: CMS will release a Notice of Funding Opportunity (NOFO) in early 2026, with the first cohort launching on September 1, 2026.

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The Cost of the Status Quo: Why Modifiable Risks Matter

The urgency behind CMS Elevate is driven by a staggering economic reality. Research indicates that 27% of all U.S. healthcare spending—totaling approximately $730.4 billion annually—is directly attributable to modifiable risk factors.

For payers and providers, the data reveals that these five metabolic and behavioral risks are the primary drivers of this financial burden:

• High BMI: $238.5 billion
• High Systolic Blood Pressure: $179.9 billion
• High Fasting Plasma Glucose: $171.9 billion
• Dietary Risks: $143.6 billion
• Tobacco Smoke: $130.0 billion

The impact is most severe in the 65+ population, where 45.5% of healthcare spending is linked to these preventable risks. CMS Elevate is designed to pivot the system toward addressing these root causes, particularly for chronic conditions like cardiovascular disease and diabetes, which account for the largest shares of attributable spending.

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How Ash Can Support ELEVATE Applications

As the MAHA ELEVATE model prioritizes data collection and out-of-clinic health practices, organizations need a reliable partner to bridge the gap between lifestyle interventions and clinical validation. Ash offers a sophisticated, white-label platform designed to help you meet these new standards.

According to ELEVATE, proposals should provide data showing outcomes from their own program implementation prior to applying. With the ability to test for a wide range of biomarkers (see our full test menu), powerful data collection tools, and seamless API integration capabilities, Ash can provide the clinical validation needed to bolster your application. 

If you’re interested in learning more about Ash, our gap closure solutions, or ways to collaborate, we’d love to talk. 

For more on MAHA ELEVATE, see here.