Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tom Price (background, left) and Seema Verma (foreground, right) want to revamp Medicare's test lab. Photo: Alex Brandon / AP

Tom Price, Seema Verma and other top Trump administration health care officials put out a notice this week that they want to overhaul the direction of the Center for Medicare and Medicaid Innovation — an agency created by the Affordable Care Act to test different ways to pay for and deliver health care. The goal: roll out conservative, "market-driven" health policy ideas.

Why it matters: The Innovation Center, unknown to most Americans, holds a lot of power in trying new health care experiments that attempt to lower costs and improve quality. But some health policy observers are worried the Trump administration is changing course with minimal transparency and eyeing radical changes to Medicare and Medicaid.

What the Innovation Center does: It builds health care experiments to test on a small scale. If they are successful, the agency could roll them out more broadly. Some of the Innovation Center's most well-known tests involve bundled payments (paying hospitals and doctors fixed prices for procedures), accountable care organizations (providers caring for a common population and being paid based on quality), and using primary care at home.

  • Worth noting: Price, the secretary of Health and Human Services, recently scaled back the center's bundled payment experiments, arguing that making the programs mandatory was a government overreach.
  • Also: CMS put out its request for information just days after Patrick Conway, a top Medicare official who ran the center and proposed some experiments that angered the industry, left to become CEO of Blue Cross Blue Shield of North Carolina.

What's changing: The Centers for Medicare and Medicaid Services, the agency run by Verma that oversees the Innovation Center, made it clear it wants to pursue conservative policies, although some ideas were vague:

  • "Consumer-directed" models that could involve patients paying more for their own care out of pocket. Medicare and Medicaid beneficiaries usually don't have a lot of disposable income.
  • Models that would allow Medicare beneficiaries "to contract directly with healthcare providers." Price, an orthopedic surgeon, supported private contracting in Congress, but critics worry patients could be on the hook for higher bills.
  • Changes to Medicare's prescription drug benefits that "engage beneficiaries as consumers of their care" — another likely reference to shopping and more out-of-pocket spending.
  • Value-based drug contracts between Medicare and drug companies, like what Novartis is doing for its new cancer therapy.

What's not changing: The view that "fee-for-service is not the most efficient way to pay for health care," said Mark McClellan, the former CMS administrator under former President George W. Bush. McClellan said he supported what the center was doing, but "it's important to view this as a first step."

Yes, but: "There's some very industry-friendly ideas in this (request for information)," said Aisling McDonough, a former CMS staff member who worked during the Obama administration. Some health policy observers also think the Trump administration has the power to pursue more controversial projects, like premium support for Medicare, through the Innovation Center.

Keep in mind: This process is lacking some transparency. CMS said it will not respond to questions or comments, unlike the process for proposing formal rules.

Go deeper

The Exvangelicals

Illustration: Aïda Amer/Axios

Even as evangelicals maintain their position as the most popular religion in the U.S., a movement of self-described "exvangelicals" is breaking away, using social media to engage tens of thousands of former faithful.

The big picture: Donald Trump's presidency, as well as movements around LGBTQ rights, #MeToo and Black Lives Matter, drew more Americans into evangelical churches while also pushing some existing members away.

Updated 4 hours ago - Science

Huge wildfire reaches edge of Sequoia National Park

A plume of smoke and flames rise into the air as the fire burns towards Moro Rock during the KNP Complex fire in the Sequoia National Park near Three Rivers, California, on Saturday. Photo: Patrick T. Fallon/AFP via Getty Images

Firefighters in Sequoia National Park were working into the night after two wildfires merged to reach the Giant Forest Saturday.

Why it matters: This forest contains over 2,000 giant sequoias, including the General Sherman Tree — the world's largest tree by volume. Park officials wrapped the redwoods in foil last week as the Paradise and Colony Fires, now known as the KNP Complex Fire, neared. Protection efforts appeared to be working overnight.

5 hours ago - World

Hong Kong holds first "patriots only" elections

Hong Kong Chief Executive Carrie Lam during a news conference last Monday. Photo: Lui Siu Wai/Xinhua via Getty Images

Hong Kong's elections to choose the city's Election Committee members opened to a select group of voters on Sunday, under a new "patriots only" system imposed by China's government.

Why it matters: All candidates running to be members of the electoral college have been "vetted" by Beijing, per Reuters. They will go on to choose the Asian financial hub's next leader, approved by China's government, and some of its legislature.