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

  • 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.

  • 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.

  • Health Plan Models:

    Models comprising Medicare Advantage plans.

  • 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.

  • 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.

  • Statutory Models:

    Models and demonstrations requiring testing as determined by Congress and/or the Secretary of Health and Human Services.

Stages

  • Announced:

    Model has been approved but not begun.

  • Announced - Accepting Applications:

    Model has an active Request for Applications (RFA).

  • Announced - Applications Under Review:

    The application period has ended; applicants will be notified directly.

  • Active:

    Model is preparing for implementation, performing currently, or has an ongoing evaluation.

  • Authorized for Expansion:

    Model has been certified for expansion through rule-making.

  • Not Active:

    Model has ended and evaluations are complete.

  • Withdrawn:

    Model will not be implemented.


    Page Last Modified:
    04/03/2024 02:09 PM