Medicare’s new model could redefine pharmacy’s future
For years, those of us in pharmacy and healthcare have asked: Will Medicare ever seriously invest in prevention, not just treatment? Now, something quietly seismic has happened. Amid the noise of new drugs and changing guidelines, CMS has launched a new payment model that, if you look closely, could change everything about the way we approach chronic disease, wellness, and the practice of pharmacy itself.
Let’s talk about the MAHA ELEVATE model.
What is MAHA ELEVATE?
MAHA ELEVATE stands for Make America Healthy Again: Enhancing Lifestyle and Evaluating Value based Approaches Through Evidence. It’s a voluntary, three year Medicare initiative funded with $100 million that will support up to 30 programs across the country. The focus? Testing if lifestyle and functional medicine, nutrition, movement, sleep, stress management, and behavior change, can truly improve outcomes and lower costs for Medicare beneficiaries.
In other words, CMS is finally asking: What if we paid as much attention to food, movement, sleep, and stress as we do to medication lists and procedures?
Programs must go beyond what Medicare typically covers. Every project must include a strong nutrition or physical activity component and demonstrate real, measurable improvement in patient health. The first round of funding launches in September 2026.
Why this matters: A quiet revolution in prevention
Let’s be clear: Medicare has always been about treating illness after it appears. Lifestyle medicine, despite solid evidence, rarely gets reimbursed. That’s why this is such a big deal.
With MAHA ELEVATE, CMS is making a statement:
- If prevention saves money and improves lives, we’ll pay for it.
- If data show that food, movement, and sleep matter, they’ll soon be part of “medical care.”
- If this works, permanent Medicare coverage for prevention could be on the horizon.
This is proactive care, not reactive care. Whole person health, not siloed specialties.
And that’s where pharmacy comes in.
What’s at stake for pharmacy?
Pharmacists are the most accessible health professionals in our system. This new model unlocks fresh, meaningful ways for us to get involved:
1. Pharmacists as essential partners in lifestyle-integrated care
Lifestyle changes affect meds, and vice versa.
- Diet shifts change drug absorption.
- Exercise alters insulin sensitivity.
- Weight loss can reduce the need for antihypertensives.
As these programs roll out for Medicare patients (many with high medication burdens), pharmacists will be the glue that holds it all together. Expect rising demand for:
- Medication therapy management inside lifestyle programs
- Deprescribing consultations
- Medication-lifestyle interaction reviews
- Patient education about everything from GLP-1s to supplements
2. New roles on interdisciplinary preventive teams
MAHA ELEVATE encourages a team approach, clinicians, lifestyle medicine practitioners, dietitians, and now, pharmacists. We’ll be needed for:
- Identifying which meds contribute to chronic conditions
- Monitoring labs, vitals, and data from wearables
- Ensuring meds align with program goals
- Coaching patients through change and adherence
- Reducing medication burden as health improves
3. The path to reimbursement for pharmacist services
MAHA ELEVATE won’t rewrite Medicare rules overnight. But the data could:
- Show that pharmacist driven care improves outcomes and saves money
- Make the case for pharmacist reimbursement under Medicare Part B
- Expand coverage for pharmacist-led preventive care, MTM, chronic disease management, and coaching
4. A push to grow new skills
To play a central role, pharmacists will need fresh skills:
- Basics of lifestyle medicine
- Nutrition and metabolic health
- Motivational interviewing
- Exercise literacy
- Wearable-driven monitoring
- Deprescribing frameworks
This is the evolution we’ve long discussed, pharmacists as total health strategists.
Bottom line: CMS is opening a door. Pharmacy needs to walk through it.
MAHA ELEVATE is more than a pilot, it’s a signal:
- Lifestyle medicine is moving from “nice to have” to “essential.”
- Prevention is being valued, not just talked about.
- Pharmacists are poised to become core contributors to the next era of value based care.
The question is, will we step up? Will we be ready to claim our seat at the table when prevention and lifestyle medicine get the recognition (and funding) we’ve always known they deserve?
I’d love to hear your thoughts. How could your practice evolve to meet this moment? What skills do you want to build to be part of the future?
Let’s not just watch this door open. Let’s walk through it, together.
Reference: Centers for Medicare & Medicaid Services. (2024). Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE). https://www.cms.gov/priorities/innovation/innovation-models/maha-elevate
