Increasing Alignment
While 2025 has often been described as “uncertain” and “ever-changing”, those qualities aren’t unique to this specific moment—they’re constants of any era. What does feel different, though, is a growing alignment across the health IT and health policy landscape. Over the past year, rapid advances in technology and AI applications, broader access to high-quality data, improved interoperability, strong public-private collaboration, and a heightened sense of urgency to deliver better value and improve care for patients have created conditions for real progress. For the first time in a long time, it feels as though these developments may genuinely begin to move the needle on deeply entrenched system failures.
Facing the Challenges of Disruption
This is not said lightly, as this has been a year of hardship and disruption for many beneficiaries of Medicaid/SNAP/CHIP, rural communities, vulnerable populations, safety net providers, and community partners supporting whole-person care. Funding structures have been altered, and more cuts are coming. Perhaps the reason the year has been described as “uncertain” or “ever-changing” is because disruption is everywhere and not expected to slow down. Hence, the reference to urgency and looking at problems through a new lens to create innovative solutions.
Reflecting on New Developments This Year
As I reflect on key developments from 2025—such as CMS’s Health Tech Ecosystem, the Rural Health Transformation Program carve-out within HR1, and new care models like ACCESS—I find myself regularly considering the intricacies of our industry while also being inspired by the call for integration, new ideas, and industry-driven solutions, and encouraged by the structure of Civitas Networks for Health®. It is, after all, new but built on two decades of experience (NRHI + SHIEC).
In many ways, the Civitas network serves as a microcosm of what CMS is building through the Health Tech Ecosystem. CMS’s ability to use government to clear the major structural barriers and then invite private sector partners to innovate and build new pathways aligns closely with Civitas’ model of bringing data-driven, community-governed nonprofits and state-led entities into closer alignment with national mission-affiliated groups and strategic technology business partners. Together, these approaches signal a more coordinated, purposeful infrastructure for solving complex challenges and arriving at sustainable solutions.
Creating an ecosystem requires intentional design at the outset, but its evolution is often organic. The past six months have illustrated this clearly. Since the release of the Health Tech Ecosystem RFI in May, multiple convenings of early adopters and pledgees have taken place. There is real value in bringing talented, determined people into the same room to rally around a bold vision and begin the work of co-creating solutions. This happened again last week with the launch of CMS’s Innovation Center’s ACCESS Model. With each gathering building on the next, the conversations have deepened, the demonstrations have become more substantive, and the path forward has gained clarity. What began as a seemingly tech-centric initiative is now emerging as a far more sophisticated, matrixed approach to structural change.
Signing the Pledge, Keeping Nonprofits at the Table
Civitas has signed the pledge as a “Friend of the Health Tech Ecosystem” to signal our support, get more industry stakeholders involved in the effort, and bring educational opportunities back to our members as they assess what this means for their work and communities. Civitas’ approach is rooted in multi-stakeholder, data-driven, community-centric collaboration, and we focus on delivering change at the local level but supporting national aims for health improvement. Our ability to mobilize and strengthen the vision of our federal partners is critically important. Nonprofit collaborators also have a uniquely strong role to play in the current landscape where trust frameworks are paramount. The need for inclusive governance structures, trusted relationships, accountability, and responsible stewardship has never been greater—and these are precisely the areas where mission-driven organizations excel. By connecting these strengths to federal initiatives and industry innovation, we can help ensure that the emerging ecosystem is both effective and equitable.
Looking Ahead
As we get ready for 2026, expect to see more educational events and opportunities to engage in discussions related to the Health Tech Ecosystem, the Rural Health Transformation Program, new payment models, and examples of important industry partnerships from Civitas. There will be renewed focus on alignment opportunities and showcasing the relevance of collaboration and trusted governance structures. It is an exciting opportunity for our community to rise to the occasion while delivering continued value to the communities we serve.
