Innovation Models
Innovation Models
The CMS Innovation Center develops and implements payment and service delivery models (pilot programs) and conducts Congressionally-mandated demonstrations to support health care transformation and increase access to high-quality care.1
The Innovation Center is committed to designing models that are inclusive of a variety of providers, including those who care for underserved populations. Learn more about the Center’s strategic direction.
View currently enrolling models and demonstrations.
1 Models and demonstration projects are exempt from the Common Rule under 45 CFR 46.104(d)(5). For additional guidance, refer to the OHRP Revised Common Rule Q&As on Exemptions
Categories
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Accountable Care Models:
Models in which a doctor, group of health care providers or hospital takes financial responsibility for improving quality of care, including advanced primary care services, care coordination and health outcomes for a defined group of patients, thereby reducing care fragmentation and unnecessary costs for patients and the health system.
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Disease-Specific & Episode-Based Models:
Models which aim to address deficits in care for a defined population with a specific shared disease or medical condition, procedure, or care episode.
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Health Plan Models:
Models comprising Medicare Advantage plans.
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Prescription Drug Models:
Models that seek to improve access to and/or the affordability of prescription drugs covered under Medicare (Part B and D) or Medicaid.
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State & Community-Based Models:
Models in which a state or community-based organization serves as the main contractual participant, including managed care organizations serving Medicaid beneficiaries.
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Statutory Models:
Models and demonstrations requiring testing as determined by Congress and/or the Secretary of Health and Human Services.
Stages
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Announced:
Model has been approved but not begun.
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Announced - Accepting Applications:
Model has an active Request for Applications (RFA).
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Announced - Applications Under Review:
The application period has ended; applicants will be notified directly.
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Active:
Model is preparing for implementation, performing currently, or has an ongoing evaluation.
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Authorized for Expansion:
Model has been certified for expansion through rule-making.
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Not Active:
Model has ended and evaluations are complete.
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Withdrawn:
Model will not be implemented.