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.

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  • Withdrawn: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:
    04/24/2024 10:56 AM