Adam Boehler took the reins of the powerful CMS Innovation Center in early 2018, pledging to help shift the U.S. health care system away from fee-for-service. Eighteen months later, he's leaving the agency, having launched a series of payment pilots that Boehler vows will lead to dramatic changes.

Boehler sat down with POLITICO's Dan Diamond to discuss why he originally took the job, how he evaluated possible payment reforms and why he thinks the Trump administration didn't fear "sacred cows" in health care.

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Boehler founded multiple companies before joining the government, including Landmark Health, which focused on serving the sickest patients.

Boehler helped steer major payment pilots at the innovation center, including an effort to reshape kidney care.

The CMS Innovation Center could be eliminated if the Affordable Care Act is struck down in court.

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