[{"Model Name":"Accountable Health Communities Model","Stage":"Not Active","Number of Participants":"28","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The Accountable Health Communities Model tested whether addressing unmet health-related social needs could reduce health care costs and utilization among community Medicare and Medicaid beneficiaries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,CO,CT,GA,IL,IN,KY,MD,MI,MN,NJ,NM,NY,OH,OK,OR,PA,TN,TX,VA,WV","Keywords":"State \u0026 Community-Based Models, Accountable Health Communities Model, AHC Model, Medicare, Medicaid, community services, social needs, health related social needs, bridge organizations, clinical-community collaboration, community services","URL":"\/initiatives\/ahcm\/","Display Model Summary":"TRUE","Unique ID":"1"},{"Model Name":"ACO Investment Model","Stage":"Not Active","Number of Participants":"45","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The ACO Investment Model tested new pre-payment approaches meant to support Medicare Shared Savings Program ACOs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CA,OK,MN,KS,MS,WV,TX,KY,ME,NC,FL,IA,WI,IL,MO,MI,NH,VT,OH,PA,WA,AL,SC,GA,SD,OR,MT,ID,WY,TN,SD,NE,NM,CO","Keywords":"Accountable Care Models, ACO Investment Model, Accountable Care Organization, Medicare Shared Savings Program, Advance Payment ACO Model, Pioneer ACO Model, rural areas","URL":"\/initiatives\/ACO-Investment-Model\/","Display Model Summary":"TRUE","Unique ID":"2"},{"Model Name":"ACO REACH","Stage":"Active","Number of Participants":"73","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The redesigned Model reflects the Biden-Harris Administration priorities and responds to stakeholder and participant feedback.  With ACO REACH, CMS will test a model that can inform the Medicare Shared Savings Program and future models by making important changes to the GPDC Model.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Models, ACO Investment Model, Accountable Care Organization, Medicare Shared Savings Program, Advance Payment ACO Model, Pioneer ACO Model, rural areas, ACO Reach Model, primary care","URL":"\/innovation-models\/aco-reach","Display Model Summary":"TRUE","Unique ID":"3"},{"Model Name":"Advance Payment ACO Model","Stage":"Not Active","Number of Participants":"35","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The Advance Payment ACO Model provided upfront and monthly payments to 35 ACOs participating in the Medicare Shared Savings Program.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"NC,KY,NH,FL,TX,RI,TN,CA,MA,MD,MS,CT,IN,AR,MO,OH,NE","Keywords":"Accountable Care Models, Accountable Care, ACOs, Advance Payment ACO Model, Accountable Care Organizations (ACOs), rural, Medicare, Shared Savings Program, prospective payment","URL":"\/initiatives\/Advance-Payment-ACO-Model\/","Display Model Summary":"TRUE","Unique ID":"4"},{"Model Name":"Artificial Intelligence (AI) Health Outcomes Challenge","Stage":"Not Active","Number of Participants":"7","Category":"Statutory Demonstrations and Other Projects","Authority":"America COMPETES Reauthorization Act","Description":"Competition to innovate how artificial intelligence (AI) can be implemented in current and new health care payment and service delivery models.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Artificial Intelligence (AI) Health Outcomes Challenge, Statutory Models, technology, competition, Medicare, Medicaid, big data","URL":"\/initiatives\/artificial-intelligence-health-outcomes-challenge\/","Display Model Summary":"TRUE","Unique ID":"5"},{"Model Name":"BPCI Advanced","Stage":"Active","Number of Participants":"170 Participants, 208 Episode Initiators","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"BPCI Advanced is a voluntary episode payment model that will qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program to test a new iteration of bundled payments.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,IA,IL,KS,KY,LA,ME,MD,MI,MN,MO,MS,MT,NC,ND,NE,NJ,NM,NV,NY,OK,OR,PA,PR,SC,SD,TN,TX,UT,VA,WA,WI,WV","Keywords":"Disease-Specific \u0026 Episode-Based Models, BPCI Advanced, Bundled Payments for Care Improvement Advanced, Advanced Alternative Payment Model (APM), episode of care, Medicare","URL":"\/initiatives\/bpci-advanced\/","Display Model Summary":"TRUE","Unique ID":"6"},{"Model Name":"Bundled Payments for Care Improvement (BPCI) Initiative: General Information","Stage":"Not Active","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"","Description":"The Bundled Payments for Care Improvement intitiative evaluated 4 different models of bundled payments for a defined episode of care to incentivize care redesign.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, Bundled Payments for Care Improvement (BPCI) Initiative: General Information, BPCI, Medicare, prospective payment, BPCI Model 1: Retrospective Acute Care Hospital Stay Only, BPCI Model 2: Retrospective Acute \u0026 Post Acute Care Episode, BPCI Model 3: Retrospective Post Acute Care, BPCI Model 4: Prospective Acute Care Hospital Stay Only","URL":"\/initiatives\/Bundled-Payments\/","Display Model Summary":"TRUE","Unique ID":"7"},{"Model Name":"CHART Model","Stage":"Withdrawn","Number of Participants":"4","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to empower rural communities to develop a high quality care delivery system through new seed funding, payment structures, operational and regulatory flexibilities and technical and learning support.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Community Health Access and Rural Transformation (CHART) Model, rural health, Disease-Specific \u0026 Episode-Based Models, Medicare, hospitals, Critical Access Hospitals (CAHs), CHART Model","URL":"\/initiatives\/chart-model","Display Model Summary":"TRUE","Unique ID":"8"},{"Model Name":"Community-based Care Transitions Program","Stage":"Not Active","Number of Participants":"18","Category":"Statutory Demonstrations and Other Projects, State \u0026 Community-Based Models","Authority":"Section 3026 of the Affordable Care Act","Description":"The Community-Based Care Transition Program supported community-based organizations to reduce readmissions by improving transitions of high-risk Medicare beneficiaries from the inpatient hospital setting to home or other care settings.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CA,IL,NY,AZ,PA,MA,MI,OH,NC,AL,IN,KY","Keywords":"Statutory Models, Partnership for Patients, Nationwide, Hospital-Acquired Conditions, Readmissions, CCTP, Community-Based Care Transitions Program, Medicare, Hospital Engagement Networks","URL":"\/initiatives\/CCTP\/","Display Model Summary":"TRUE","Unique ID":"9"},{"Model Name":"Comprehensive Care for Joint Replacement Model","Stage":"Active","Number of Participants":"Approximately 324 hospitals in 34 MSAs","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to improve care and reduce costs for hip and knee replacements through episode-based payments.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AR CA,CT,FL,IN,KY,MS,NC,NY,NJ,OH,PA,TX,UT","Keywords":"Comprehensive Care for Joint Replacement Model, Disease-Specific \u0026 Episode-Based Models, lower extremity joint replacement, hip replacement, knee replacement, surgeries, CJR Model","URL":"\/initiatives\/cjr\/","Display Model Summary":"TRUE","Unique ID":"10"},{"Model Name":"Comprehensive ESRD Care Model","Stage":"Not Active","Number of Participants":"33","Category":"Accountable Care Models, Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The Comprehensive ESRD Care Model was designed to improve care for beneficiaries with ESRD while lowering Medicare costs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AZ,CA,DE,FL,GA,IL,IN,LA,MA,MD,MI,MN,MO,NC,NJ,NY,NV,OH,OR,PA,SC,TN,TX,WA","Keywords":"Disease-Specific \u0026 Episode-Based Models, comprehensive esrd care model, esrd, end-stage renal disease, dialysis, Medicare, CEC Model","URL":"\/initiatives\/comprehensive-ESRD-care\/","Display Model Summary":"TRUE","Unique ID":"11"},{"Model Name":"Comprehensive Primary Care Initiative","Stage":"Not Active","Number of Participants":"442","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The CPC Initiative was a multi-payer initiative that provided financial support to primary care practices in 7 markets.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"NY,NJ,CO,OK,AR,OH,OR,KY","Keywords":"Accountable Care Models, Comprehensive Primary Care Initiative, Medicare, managed care, multi-payer, CPCI","URL":"\/initiatives\/Comprehensive-Primary-Care-Initiative\/","Display Model Summary":"TRUE","Unique ID":"12"},{"Model Name":"Comprehensive Primary Care Plus","Stage":"Not Active","Number of Participants":"2610","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"A national advanced primary care medical home model that aimed to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR,CO,HI,KS,KY,MO,MI,MT,NJ,NY,OH,OK,OR,PA,RI,TN","Keywords":"Accountable Care Models, Comprehensive Primary Care Plus, CPC+, CPC+ Model, primary care, medical home","URL":"\/initiatives\/comprehensive-primary-care-plus\/","Display Model Summary":"TRUE","Unique ID":"13"},{"Model Name":"Emergency Triage, Treat, and Transport (ET3) Model","Stage":"Not Active","Number of Participants":"152","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Voluntary payment model that provided greater ambulance care team flexibility to address Medicare beneficiary emergency care needs following a 911 call.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AZ,CA,CO,CT,FL,GA,HI,IL,KS,KY,LA,MA,MD,ME,MI,MO,MO,NC,NH,NJ,NM,NV,NY,OH,OK,OR,PA,SC,SD,TN,TX,VA,WV,WI","Keywords":"Disease-Specific \u0026 Episode-Based Models, Emergency Triage, Treat, and Transport (ET3) Model, ET3, ambulance, 911, Medicare, emergency, triage, care in place, ET3 Model","URL":"\/initiatives\/et3\/","Display Model Summary":"TRUE","Unique ID":"14"},{"Model Name":"EOM (Enhancing Oncology) Model","Stage":"Active","Number of Participants":"28 practices, 1 payer","Category":"Disease-Specific \u0026 Episode-Based Models, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to drive transformation and improve oncology care coordination by preserving and enhancing the quality of care furnished to beneficiaries undergoing treatment for cancer while reducing program spending under Medicare fee-for-service.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AR,AZ,CA,CO,CT,DC,FL,GA,ID,IL,IN,KY,LA,MD,MI,MN,MO,MS,MT,NC,NJ,NM,NV,OH,OK,OR,PA,SC,TN,TX,VA,WA,WV ","Keywords":"Enhancing Oncology Model (EOM), Disease-Specific \u0026 Episode-Based Models, oncology, cancer","URL":"\/innovation-models\/enhancing-oncology-model","Display Model Summary":"TRUE","Unique ID":"15"},{"Model Name":"ESRD Treatment Choices (ETC) Model","Stage":"Not Active","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Encourages greater use of home dialysis and kidney transplants for Medicare beneficiaries with ESRD, while reducing Medicare expenditures and preserving or enhancing the quality of care furnished to beneficiaries with ESRD.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, ESRD Treatment Choices (ETC) Model, end-stage renal disease, kidney, Advancing American Kidney Health Executive Order, ETC Model, dialysis, kidney transplants","URL":"\/initiatives\/esrd-treatment-choices-model\/","Display Model Summary":"TRUE","Unique ID":"16"},{"Model Name":"Expanded Home Health Value-Based Purchasing Model","Stage":"Active","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Building upon experience from the original Home Health Value-Based Purchasing Model (HHVBP Model), this model expands presence to all fifty states, District of Columbia, and the U.S. territories.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Expanded Home Health Value-Based Purchasing Model, Expanded HHVBP Model, HHVBP, Disease-Specific \u0026 Episode-Based Models, Medicare, home health","URL":"\/innovation-models\/expanded-home-health-value-based-purchasing-model","Display Model Summary":"TRUE","Unique ID":"17"},{"Model Name":"Financial Alignment Initiative for Medicare-Medicaid Enrollees","Stage":"Active","Number of Participants":"13","Category":"State \u0026 Community-Based Models, Health Plan Models","Authority":"Section 1115A of the Social Security Act","Description":"Enables states to integrate care and payment systems for Medicare-Medicaid enrollees and better coordinate their care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MA,WA,OH,IL,CA,VA,NY,SC,RI,MN,CO,MI,TX","Keywords":"State \u0026 Community-Based Models, Financial Alignment Initiative, dual eligibles, Medicare, Medicaid, Medicare-Medicaid enrollees, Financial Alignment Initiative for Medicare-Medicaid Enrollees, FAI","URL":"\/initiatives\/Financial-Alignment\/","Display Model Summary":"TRUE","Unique ID":"18"},{"Model Name":"FQHC Advanced Primary Care Practice Demonstration","Stage":"Not Active","Number of Participants":"434","Category":"Statutory Demonstrations and Other Projects, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration tested the efficiency of patient-centered medical homes among FQHCs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"WA,WI,CA,GA,LA,IL,WV,KY,ID,NH,AK,NC,AR,MI,HI,MD,TX,SC,IA,MI,NM,MO,PA,MS,OH,NJ,NY,IN,MS,TN,SD,OR,VA,CO,NE,MT,FL,MA,CT,WY,MN,KY,RI,ND,ID,ME,AL,KS,OK,AL,OR","Keywords":"Statutory Models, Federally Qualified Health Center (FQHC), medical home, Medicare, managed care, Medicaid, dual eligibles, Medicare, FQHC Advanced Primary Care Practice Demonstration","URL":"\/initiatives\/FQHCs\/","Display Model Summary":"TRUE","Unique ID":"19"},{"Model Name":"Frontier Community Health Integration Project Demonstration","Stage":"Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 3126 of the Affordable Care Act","Description":"This demonstration aimed to develop and test new models of integrated, coordinated health care in the most sparsely populated rural counties.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MT,NV,ND","Keywords":"Statutory Models, Frontier Community Health Integration Project Demonstration, Medicare, critical access hospitals (CAHs), rural, telemedicine, home health, home-based care, ambulance, remote geographic areas","URL":"\/initiatives\/Frontier-Community-Health-Integration-Project-Demonstration\/","Display Model Summary":"TRUE","Unique ID":"20"},{"Model Name":"Frontier Extended Stay Clinic Demonstration","Stage":"Not Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 434 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003","Description":"The Frontier Extended Stay Clinic Demonstration allowed remote clinics to treat patients for more extended periods, including overnight stays, that are entailed in routine physician visits.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,WA","Keywords":"Statutory Models, Frontier Extended Stay Clinic Demonstration, acute care, remote geographic areas","URL":"\/initiatives\/Frontier-Extended-Stay-Clinic\/","Display Model Summary":"TRUE","Unique ID":"21"},{"Model Name":"Geographic Direct Contracting Model","Stage":"Not Active","Number of Participants":"","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"A payment and care delivery model that proposed testing whether a geographic-based approach to care delivery and value-based care could improve health and reduce costs for Medicare beneficiaries across an entire geographic region.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Models, Geographic Direct Contracting Model, Direct Contracting Model Options, DC, primary care, voluntary, value, quality, flexibility","URL":"\/innovation-models\/geographic-direct-contracting-model","Display Model Summary":"TRUE","Unique ID":"22"},{"Model Name":"Global and Professional Direct Contracting (GPDC) Model","Stage":"Not Active","Number of Participants":"99","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"Voluntary payment model options that innovated Medicare fee-for-service approaches to produce value and high-quality care outcomes.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Models, Global and Professional Direct Contracting (GPDC) Model, GPDC Model, Direct Contracting Model Options, DC, primary care, voluntary, value, quality, flexibility","URL":"\/innovation-models\/gpdc-model","Display Model Summary":"TRUE","Unique ID":"23"},{"Model Name":"Graduate Nurse Education Demonstration","Stage":"Not Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 5509 of the Affordable Care Act","Description":"The Graduate Nurse Education Demonstration supported hospitals for the reasonable cost of providing clinical training to advanced practice registered nursing (APRN) training.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"PA,NC,AZ,IL,TX","Keywords":"Statutory Models, Graduate Nurse Education Demonstration, GNE, Advanced Practice Registered Nurses (APRNs), Medicare","URL":"\/initiatives\/GNE\/","Display Model Summary":"TRUE","Unique ID":"24"},{"Model Name":"Health Care Innovation Awards","Stage":"Not Active","Number of Participants":"107","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"The Health Care Innovation Awards funded competitive grants to compelling new ideas that deliver health care at lower costs to people enrolled in Medicare, Medicaid, and CHIP.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MA,TX,NJ,MN,SD,NC,GA,PA,OR,MD,VA,DC,RI,CT,VT,NM,WA,CA,NH,NE,IL,NY,OH,CO,TN,MI,WI,DE,AR,MO,SC,FL,HI,MT,WY,UT,ID,ME,IA,OK,AZ,IN,ND,AK,NV,ND,AL,PR,OR,KS,KY,MS,WV,ID,LA","Keywords":"Health Care Innovation Awards, Statutory Models, Medicare, Medicaid, Children\u0027s Health Insurance Program (CHIP), CHIP, grants, HCIA, Challenge, managed care, community health, rural","URL":"\/initiatives\/Health-Care-Innovation-Awards\/","Display Model Summary":"TRUE","Unique ID":"25"},{"Model Name":"Health Care Innovation Awards Round Two","Stage":"Not Active","Number of Participants":"39","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"The Health Care Innovation Awards Round Two were funding competitive grants to compelling new ideas that delivered health care at lower costs to people enrolled in Medicare, Medicaid, and CHIP.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,CA,CO,CT,DC,FL,GA,IA,IL,KS,MA,MD,MI,MN,MO,NE,NC,NH,NM,NY,OH,PA,SD,TX,WA,WI,VA","Keywords":"Statutory Models, Health Care Innovation Awards Round Two, HCIA Round Two, grants","URL":"\/initiatives\/Health-Care-Innovation-Awards\/Round-2.html","Display Model Summary":"TRUE","Unique ID":"26"},{"Model Name":"Home Health Value-Based Purchasing Model","Stage":"Authorized for Expansion","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model was designed to support greater quality and efficiency among Medicare-certified home health agencies by shifting away from payments based on volume towards payments based on quality.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,FL,IA,MA,MD,NE,NC,TN,WA","Keywords":"Disease-Specific \u0026 Episode-Based Models, Home Health Value-Based Purchasing Model, Medicare, value based, HHVBP Model, HHVBP","URL":"\/initiatives\/home-health-value-based-purchasing-model","Display Model Summary":"TRUE","Unique ID":"27"},{"Model Name":"Independence at Home Demonstration","Stage":"Not Active","Number of Participants":"1 Participating Site","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 3024 of the Affordable Care Act as amended by the Bipartisan Budget Act of 2018","Description":"The Independence at Home Demonstration supported home-based primary care for Medicare beneficiaries with multiple chronic conditions.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MA,DE,OH,NY,NC,OR,PA,TX,FL,MI,VA,WI","Keywords":"Statutory Models, Independence at Home Demonstration, Medicare, home-based care, chronic conditions","URL":"\/initiatives\/Independence-at-Home\/","Display Model Summary":"TRUE","Unique ID":"28"},{"Model Name":"Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents","Stage":"Not Active","Number of Participants":"7","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Offered enhanced clinical services to beneficiaries in extended-care nursing facilities.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,IN,MO,NE,NV,NY,PA","Keywords":"Disease-Specific \u0026 Episode-Based Models, Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents, Partnership for Patients, Medicare-Medicaid enrollees, dual eligibles, Medicaid, Medicare","URL":"\/initiatives\/rahnfr\/","Display Model Summary":"TRUE","Unique ID":"29"},{"Model Name":"Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents: Phase Two","Stage":"Not Active","Number of Participants":"247","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Phase Two of the Initiative offering enhanced clinical services to beneficiaries in long-term care facilities.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,CO,IN,MO,NV,NY,PA","Keywords":"Disease-Specific \u0026 Episode-Based Models, Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents: Phase Two, Initiatives Focused on the Medicare-Medicaid Enrollees, dual eligible, Medicare, Medicaid, long-term care (LTC)","URL":"\/initiatives\/rahnfr-phase-two\/","Display Model Summary":"TRUE","Unique ID":"30"},{"Model Name":"InCK (Integrated Care for Kids) Model","Stage":"Active","Number of Participants":"7","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to reduce expenditures and improve the quality of care for children covered by Medicaid and the Children\u0027s Health Insurance Program (CHIP) through prevention, early identification, and treatment of behavioral and physical health needs, including substance use.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CT,IL,NC,NJ,NY,OH","Keywords":"State \u0026 Community-Based Models, Integrated Care for Kids (InCK) Model, InCK Model, Medicaid, Childrens Health Insurance Program (CHIP), substance use, pediatrics","URL":"\/initiatives\/integrated-care-for-kids-model\/","Display Model Summary":"TRUE","Unique ID":"31"},{"Model Name":"International Pricing Index (IPI) Model","Stage":"Withdrawn","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This proposed model would aim to preserve or enhance quality of care for beneficiaries while reducing Medicare Part B drug expenditures.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"International Pricing Index (IPI) Model, IPI Model, Prescription Drug Models, Medicare, Part B, Competitive Acquisition Program (CAP)","URL":"\/initiatives\/ipi-model\/","Display Model Summary":"TRUE","Unique ID":"32"},{"Model Name":"KCC (Kidney Care Choices) Model","Stage":"Active","Number of Participants":"73 KCEs","Category":"Accountable Care Models, Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model incentivizes kidney disease prevention, encourage kidney transplantation and offer distinct payment options to further these goals.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,CA,GA,FL,IL,IN,KS,KY,MI,MN,MO,NC,NJ,NY,OH,OR,PA,SC,TN,TX,WA,WI,WV","Keywords":"Accountable Care Models, Kidney Care Choices (KCC) Model, Kidney Care First (KCF) Option, Comprehensive Kidney Care Contracting (CKCC) Option, Advancing American Kidney Health Executive Order, kidney, kidney transplants, dialysis, KCC Model","URL":"\/initiatives\/kidney-care-choices-kcc-model\/","Display Model Summary":"TRUE","Unique ID":"33"},{"Model Name":"Maryland All-Payer Model","Stage":"Not Active","Number of Participants":"1","Category":"State \u0026 Community-Based Models, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This Model was a partnership between CMS and the state of Maryland to modernize Maryland\u0027s unique all-payer rate-setting system for hospital services.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MD","Keywords":"State \u0026 Community-Based Models, Maryland All-Payer Model, Medicare, Medicaid, Children\u0027s Health Insurance Program (CHIP), states","URL":"\/initiatives\/Maryland-All-Payer-Model\/","Display Model Summary":"TRUE","Unique ID":"34"},{"Model Name":"Maryland Total Cost of Care Model","Stage":"Not Active","Number of Participants":"550","Category":"State \u0026 Community-Based Models, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This model is the first CMS Innovation Center model to hold a state fully at risk for the total cost of care for Medicare beneficiaries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MD","Keywords":"State \u0026 Community-Based Models, Maryland Total Cost of Care Model, TCOC, Maryland, Medicare, Outcomes-Based Credits, Substance-Use Disorder (SUD), Diabetes, Hypertension, Obesity, Smoking, Asthma, MD TCOC Model","URL":"\/initiatives\/md-tccm\/","Display Model Summary":"TRUE","Unique ID":"35"},{"Model Name":"Maternal Opioid Misuse (MOM) Model","Stage":"Not Active","Number of Participants":"7","Category":"State \u0026 Community-Based Models, Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model addressed the need to better align and coordinate care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CO,IN,ME,NH,TN,TX,WV","Keywords":"Maternal Opioid Misuse (MOM) Model, State \u0026 Community-Based Models, opioid, opioid use disorder (oud), Medicaid, pregnant, prenatal, peripartum, postpartum, Childrens Health Insurance Program (CHIP), pediatrics, MOM Model","URL":"\/initiatives\/maternal-opioid-misuse-model\/","Display Model Summary":"TRUE","Unique ID":"36"},{"Model Name":"Medicaid Emergency Psychiatric Demonstration","Stage":"Not Active","Number of Participants":"12","Category":"Statutory Demonstrations and Other Projects, Health Plan Models","Authority":"Section 2707 of the Affordable Care Act","Description":"The Medicaid Emergency Psychiatric Demonstration supported treatment for psychiatric emergencies at private psychiatric hospitals in 11 states and the District of Columbia.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,CA,CT,DC,IL,ME,MD,MO,NC,RI,WA,WV","Keywords":"Statutory Models, Medicaid Emergency Psychiatric Demonstration, Medicaid, Children\u0027s Health Insurance Program (CHIP)","URL":"\/initiatives\/Medicaid-Emergency-Psychiatric-Demo\/","Display Model Summary":"TRUE","Unique ID":"37"},{"Model Name":"Medicaid Incentives for the Prevention of Chronic Diseases Model","Stage":"Not Active","Number of Participants":"10","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 4108 of the Affordable Care Act","Description":"The Medicaid Incentives for the Prevention of Chronic Diseases Model supported 10 states providing incentives for Medicaid beneficiaries to participate in prevention programs and demonstrate changes in health risks and outcomes.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"WI,MN,NY,NV,NH,MT,HI,TX,CA,CT","Keywords":"Statutory Models, Medicaid Incentives for the Prevention of Chronic Diseases Model, grants, managed care","URL":"\/initiatives\/MIPCD\/","Display Model Summary":"TRUE","Unique ID":"38"},{"Model Name":"Medicaid Innovation Accelerator Program","Stage":"Not Active","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"This program aimed to support state efforts to accelerate innovations to improve health and care, while decreasing costs in the Medicaid and CHIP programs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,AL,AR,AZ,CA,CT,CO,DC,DE,FL,GA,GU,IA,IL,KS,KY,LA,MD,ME,MI,MN,MO,MP,MS,MT,NC,NH,ND,NE,NJ,NM,NV,NY,OK,OR,PA,PR,SC,SD,TN,TX,UT,VA,VT,WA,WI,WV,WY","Keywords":"Statutory Models, Medicaid, CHIP, Medicaid Innovation Accelerator Program, IAP, technical assistance, CMCS","URL":"\/initiatives\/MIAP\/","Display Model Summary":"TRUE","Unique ID":"39"},{"Model Name":"Medicare Acute Care Episode (ACE) Demonstration","Stage":"Not Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects, Disease-Specific \u0026 Episode-Based Models","Authority":"Section 646 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003","Description":"The Acute Care Episode (ACE) Demonstration tested the effect of bundling Part A and B payments for episodes of acute care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, Bundled Payments for Care Improvement (BPCI), Medicare Acute Care Episode (ACE) Demonstration, Medicare, Value-Based Care Centers","URL":"\/initiatives\/ACE\/","Display Model Summary":"TRUE","Unique ID":"40"},{"Model Name":"Medicare Advantage Value-Based Insurance Design Model","Stage":"Not Active","Number of Participants":"62 for CY 2025","Category":"Health Plan Models, Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model is testing the value of extra benefits or reductions in cost sharing for Medicare Advantage enrollees with chronic health conditions.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CT,FL,IN,MA,MI,MN,NY,OR,PA,RI,VA","Keywords":"Health Plan Models, Medicare Advantage Value-Based Insurance Design Model, Health Plan Innovation Initiatives, Medicare Advantage, value-based insurance design, HPI, Medicare, vbid, VBID, MA-VBID, chronic conditions, hospice","URL":"\/initiatives\/vbid\/","Display Model Summary":"TRUE","Unique ID":"41"},{"Model Name":"Medicare Care Choices Model","Stage":"Not Active","Number of Participants":"82","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The Medicare Care Choices Model aimed to develop innovative payment systems to improve care options for hospice eligible beneficiaries by allowing greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CA,CO,DE,FL,GA,HI,IA,ID,IL,IN,KS,KY,OH,OK,MA,MD,MI,MN,MO,MT,NC,NJ,NV,NY,PA,SC,SD,TN,TX,UT,VA,VT,WA,WI","Keywords":"Health Plan Models, Medicare Care Choices Model, hospice, Medicare, Medicaid, curative treatment, dual eligible individuals, Medicare hospice benefit, Medicaid hospice benefit, shared decision making, care coordination, MCCM","URL":"\/initiatives\/Medicare-Care-Choices\/","Display Model Summary":"TRUE","Unique ID":"42"},{"Model Name":"Medicare Coordinated Care Demonstration","Stage":"Not Active","Number of Participants":"15","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 4106 of the Balanced Budget Act of 1997","Description":"The Medicare Coordinated Care Demonstration tested whether providing coordinated care services to Medicare beneficiaries with complex chronic conditions could yield patient outcomes without increasing program costs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Statutory Models, Medicare Coordinated Care Demonstration, Medicare","URL":"\/initiatives\/Medicare-Coordinated-Care\/","Display Model Summary":"TRUE","Unique ID":"43"},{"Model Name":"MDPP (Medicare Diabetes Prevention Program) Expanded Model","Stage":"Active","Number of Participants":"941","Category":"Disease-Specific \u0026 Episode-Based Models, Health Plan Models","Authority":"Section 1115A of the Social Security Act","Description":"This program is a structured lifestyle intervention to prevent onset of diabetes in pre-diabetic individuals.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR,AZ,CA,CO,DE,FL,GA,IA,ID,IL,IN,KS,KY,MA,MD,ME,MI,MN,MT,NC,NH,ND,NY,OH,OK,OR,PA,SC,TN,TX,UT,WA,WI,WV","Keywords":"Disease-Specific \u0026 Episode-Based Models, Medicare Diabetes Prevention Program (MDPP) Expanded Model, Medicare, diabetes, MDPP","URL":"\/initiatives\/medicare-diabetes-prevention-program\/","Display Model Summary":"TRUE","Unique ID":"44"},{"Model Name":"Medicare Health Care Quality Demonstration","Stage":"Not Active","Number of Participants":"4","Category":"Accountable Care Models","Authority":"Section 646 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003","Description":"The Medicare Health Care Quality Demonstration tested major changes to improve quality of care while increasing efficiency across an entire health care system.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Models, Accountable Care, Medicare Health Care Quality Demonstration, Medicare","URL":"\/initiatives\/Medicare-Health-Care-Quality\/","Display Model Summary":"TRUE","Unique ID":"45"},{"Model Name":"Medicare Hospital Gainsharing Demonstration","Stage":"Not Active","Number of Participants":"2","Category":"Statutory Demonstrations and Other Projects","Authority":"Deficit Reduction Act of 2005 and Section 3027 of the Affordable Care Act","Description":"This demonstration tested arrangements between hospitals and physicians designed to govern the utilization of inpatient hospital resources and physician work and improve operational hospital performance with the sharing of remuneration.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Statutory Models, Medicare Hospital Gainsharing Demonstration, rural, Medicare","URL":"\/initiatives\/Medicare-Hospital-Gainsharing\/","Display Model Summary":"TRUE","Unique ID":"46"},{"Model Name":"Medicare Imaging Demonstration","Stage":"Not Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008","Description":"Collected data regarding physician use of advanced diagnostic imaging services to determine the appropriateness of services in relation to medical specialty guidelines.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Statutory Models, Medicare Imaging Demonstration, MRI, computed tomography, CT scan, nuclear medicine","URL":"\/initiatives\/Medicare-Imaging\/","Display Model Summary":"TRUE","Unique ID":"47"},{"Model Name":"Medicare Intravenous Immune Globulin (IVIG) Demonstration","Stage":"Not Active","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012","Description":"This Demonstration is being implemented to evaluate the benefits of providing payment and items for services needed for in-home administration of intravenous immune globulin for the treatment of primary immune deficiency disease (PIDD).","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Statutory Models, Medicare Intravenous Immune Globulin (IVIG) Demonstration, IVIG, primary immune deficiency disease (PIDD), home health","URL":"\/initiatives\/IVIG\/","Display Model Summary":"TRUE","Unique ID":"48"},{"Model Name":"Million Hearts","Stage":"Not Active","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over five years.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, Million Hearts, heart attacks, strokes, cardiovascular disease","URL":"\/initiatives\/Million-Hearts\/","Display Model Summary":"TRUE","Unique ID":"49"},{"Model Name":"Million Hearts: Cardiovascular Disease Risk Reduction Model","Stage":"Not Active","Number of Participants":"319","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model provided opportunity for the design of sustainable care approaches to decrease cardiovascular disease risk for Medicare beneficiaries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,AK,CA,CO,DC,WA,OR,ID,MT,UT,WY,NM,TX,OK,KS,ND,NE,MN,IA,MO,AR,LA,MS,TN,IL,WI,MI,IN,OH,AL,GA,FL,SC,NC,VA,PA,OH,NY,NJ,CT,RI,NH,ME,DE,HI,PR","Keywords":"Million Hearts: Cardiovascular Disease Risk Reduction Model, Million Hearts, CVD, Disease-Specific \u0026 Episode-Based Models, Medicare, heart attacks, stroke, predictive modelling, population-level risk management","URL":"\/initiatives\/Million-Hearts-CVDRRM\/","Display Model Summary":"TRUE","Unique ID":"50"},{"Model Name":"Most Favored Nation Model","Stage":"Withdrawn","Number of Participants":"","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Mandatory, nationwide model that tested whether more closely aligning Medicare Part B drugs payments with international prices and removing incentives to use higher-cost drugs could control unsustainable Medicare Part B spending without adversely affecting quality of care for beneficiaries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"State \u0026 Community-Based Models, Most Favored Nation Model, MFN Model, prescription drugs, Medicare Part B, Organisation for Economic Co-operation and Development (OCED), Medicare","URL":"\/innovation-models\/most-favored-nation-model","Display Model Summary":"TRUE","Unique ID":"51"},{"Model Name":"Multi-Payer Advanced Primary Care Practice","Stage":"Not Active","Number of Participants":"5","Category":"Statutory Demonstrations and Other Projects, Accountable Care Models","Authority":"Section 402 of the Social Security Amendments of 1967 as amended","Description":"In the Multi-Payer Advanced Primary Care Practice Demonstration, CMS joined in multi-payer primary care initiatives that were being conducted within states.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"ME,VT,RI,NY,MI","Keywords":"Statutory Models, Multi-payer Advanced Primary Care Practice Demonstration, medical home, APC, Medicaid, Medicare","URL":"\/initiatives\/Multi-Payer-Advanced-Primary-Care-Practice\/","Display Model Summary":"TRUE","Unique ID":"52"},{"Model Name":"Next Generation ACO Model","Stage":"Not Active","Number of Participants":"35","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This model allowed provider groups to assume higher levels of financial risk and reward than were available under the Pioneer ACO Model and Shared Savings Program through incentives and support tools.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,CA,DE,FL,IA,ID,IN,LA,MA,MI,MN,NC,NH,NY,RI,TX,UT,VA,VT,WA,WI","Keywords":"Accountable Care Models, Next Generation ACO Model, Accountable Care, Medicare, quality improvement, incentives, care coordination, alternative payment models, NGACO, Next Gen ACO Model","URL":"\/initiatives\/Next-Generation-ACO-Model\/","Display Model Summary":"TRUE","Unique ID":"53"},{"Model Name":"Nursing Home Value-Based Purchasing Demonstration","Stage":"Not Active","Number of Participants":"182","Category":"Accountable Care Models","Authority":"Section 402 of the Social Security Amendments of 1967 as amended","Description":"Nursing Home Value-Based Purchasing Demonstration provided incentive payment awards to participating nursing homes that performed the best or improve the most in terms of quality.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,NY,WI","Keywords":"Accountable Care Models, Accountable Care, Nursing Home Value-Based Purchasing Demonstration, Medicare, Medicaid","URL":"\/initiatives\/Nursing-Home-Value-Based-Purchasing\/","Display Model Summary":"TRUE","Unique ID":"54"},{"Model Name":"Oncology Care Model","Stage":"Not Active","Number of Participants":"122 practices, 5 payers","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This was an innovative payment model for physician practices administering chemotherapy that aimed to provide higher quality, more coordinated oncology care at lower cost to Medicare.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AR,AZ,CA,CT,FL,GA,IL,IN,KY,MA,ME,MI,MN,MS,NE,NJ,NM,NY,OH,OK,OR,PA,SC,TN,TX,UT,VA,WA,WI,WV","Keywords":"Disease-Specific \u0026 Episode-Based Models, Cancer, Oncology Care Model, OCM, chemotherapy, care coordination, shared decision making,  Medicare, Medicare Advantage, Medicaid","URL":"\/initiatives\/Oncology-Care\/","Display Model Summary":"TRUE","Unique ID":"55"},{"Model Name":"Part D Enhanced Medication Therapy Management Model","Stage":"Not Active","Number of Participants":"6","Category":"Health Plan Models, Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"This model tested changes to the Part D program to achieve better alignment of PDP sponsor and government financial interests, while also creating incentives for robust investment and innovation in MTM programs, lower health costs, and higher quality care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AZ,FL,IA,LA,MN,MT,NE,ND,SD,VA,WY","Keywords":"Prescription Drug Models, Part D Enhanced Medication Therapy Management Model, Health Plan Innovation Initiatives, Medicare, Part D, MTM, Part D Enhanced MTM Model, PDP, HPI, drug coverage","URL":"\/initiatives\/enhancedmtm\/","Display Model Summary":"TRUE","Unique ID":"56"},{"Model Name":"Part D Payment Modernization Model","Stage":"Not Active","Number of Participants":"2","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"This voluntary model aimed to test better alignment of prescription drug plan design improvements and incentives to improve quality and lower costs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Prescription Drug Models, Part D Payment Modernization Model, prescription drugs, Part D","URL":"\/initiatives\/part-d-payment-modernization-model\/","Display Model Summary":"TRUE","Unique ID":"57"},{"Model Name":"Part D Senior Savings Model","Stage":"Not Active","Number of Participants":"116","Category":"Prescription Drug Models, Health Plan Models","Authority":"Section 1115A of the Social Security Act","Description":"This voluntary model tests the impact of offering beneficiaries an increased choice of enhanced alternative Part D plan options that offer lower out-of-pocket costs for insulin.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,AL,AS,AR,AZ,CA,CO,CT,DC,DE,FL,FM,GA,GU,HI,IA,ID,IL,IN,KS,KY,LA,MA,MD,ME,MH,MI,MN,MO,MP,MS,MT,NE,NM,NC,ND,NH,NJ,NV,NY,OH,OK,OR,PA,PR,PW,RI,SC,SD,TN,TX,UM,UT,VA,VI,VT,WA,WI,WV,WY","Keywords":"Prescription Drug Models, Part D Senior Savings Model, Part D, Senior Savings Model, prescription drugs, Medicare, Medicare Advantage (MA), insulin, seniors","URL":"\/initiatives\/part-d-savings-model","Display Model Summary":"TRUE","Unique ID":"58"},{"Model Name":"Partnership for Patients","Stage":"Not Active","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The Partnership for Patients was a nationwide public-private partnership that offered support to physicians, nurses and other clinicians working in and out of hospitals to reduce hospital-acquired conditions and readmissions.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, Partnership for Patients, Community-based Care Transitions Program, Hospital Engagement Networks (HENs), Hospital-Acquired Conditions, Care Transitions, Medicare, Readmissions","URL":"\/initiatives\/Partnership-for-Patients\/","Display Model Summary":"TRUE","Unique ID":"59"},{"Model Name":"Pennsylvania Rural Health Model","Stage":"Active","Number of Participants":"15","Category":"State \u0026 Community-Based Models, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to increase access to high-quality care in Pennsylvania rural settings while reducing hospital expenditures across payers.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"PA","Keywords":"Pennsylvania Rural Health Model, State \u0026 Community-Based Models, rural health, PA, Pennsylvania, all-payer, PA Rural Health Model","URL":"\/initiatives\/pa-rural-health-model\/","Display Model Summary":"TRUE","Unique ID":"60"},{"Model Name":"Physician Group Practice Transition Demonstration","Stage":"Not Active","Number of Participants":"6","Category":"Accountable Care Models","Authority":"Sections 3022 and 3027 of the Affordable Care Act","Description":"A precursor to the Medicare Shared Savings Program, the Physician Group Practice Transition Demonstration rewarded groups for efficient and high quality care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Models, Accountable Care, Shared Savings Program, Medicare, Medicare Physician Group Practice Transition Demonstration, Physician Group Practice Transition Demonstration","URL":"\/initiatives\/Physician-Group-Practice-Transition\/","Display Model Summary":"TRUE","Unique ID":"61"},{"Model Name":"Physician Hospital Collaboration Demonstration","Stage":"Not Active","Number of Participants":"12","Category":"Accountable Care Models","Authority":"Section 646 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003","Description":"The Physician Hospital Collaboration Demonstration examined the effects of gainsharing aimed at improving the quality of care being delivered.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"NJ","Keywords":"Accountable Care Models, Physician Hospital Collaboration Demonstration, Medicare","URL":"\/initiatives\/Physician-Hospital-Collaboration\/","Display Model Summary":"TRUE","Unique ID":"62"},{"Model Name":"Pioneer ACO Model","Stage":"Not Active","Number of Participants":"9","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The Pioneer ACO Model rewarded groups of health care providers experienced in working together to coordinate care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MN,MA,AZ,WI,CA,MI,NY","Keywords":"Accountable Care Models, Accountable Care, ACOs, Pioneer ACO Model, Accountable Care Organizations (ACOs), Shared Savings Program, alligned beneficiaries, quality metrics, coordinated care, quality measures, Medicare","URL":"\/initiatives\/Pioneer-ACO-Model\/","Display Model Summary":"TRUE","Unique ID":"63"},{"Model Name":"Primary Care First Model Options","Stage":"Not Active","Number of Participants":"1717","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"Voluntary payment model options that reward value and quality through innovative payment structures and emphasizing the doctor-patient relationship supporting advanced primary care.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR,CA,CO,DE,FL,HI,KS,KY,LA,MA,ME,MI,MO,MT,ND,NE,NH,NJ,NY,OH,OK,OR,PA,RI,TN,VA","Keywords":"Accountable Care Models, Primary Care First Model Options, PCF, primary care, voluntary, value, quality, flexibility","URL":"\/innovation-models\/primary-care-first-model-options","Display Model Summary":"TRUE","Unique ID":"64"},{"Model Name":"Private, For-Profit Demo Project for the Program of All-Inclusive Care for the Elderly (PACE)","Stage":"Not Active","Number of Participants":"6","Category":"Statutory Demonstrations and Other Projects, State \u0026 Community-Based Models","Authority":"Section 4804 of the Balanced Budget Act of 1997","Description":"This demonstration studied the quality and cost of providing PACE program services under the Medicare and Medicaid Programs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"PA","Keywords":"Accountable Care Models, Accountable Care, Private For-Profit Demo Project for the Program of All-Inclusive Care for the Elderly (PACE), PACE, Medicare","URL":"\/initiatives\/PACE\/","Display Model Summary":"TRUE","Unique ID":"65"},{"Model Name":"Radiation Oncology Model","Stage":"Announced","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This proposed model aims to improve quality of radiotherapy treatments for cancer patients and reduce provider burden through a predictable payment system.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Disease-Specific \u0026 Episode-Based Models, Cancer, Radiation Oncology Model, radiotherapy, RO Model, radiation oncology, Advanced Alternative Payment Model, MIPS APM","URL":"\/initiatives\/radiation-oncology-model\/","Display Model Summary":"TRUE","Unique ID":"66"},{"Model Name":"Rural Community Hospital Demonstration","Stage":"Active","Number of Participants":"27","Category":"Statutory Demonstrations and Other Projects","Authority":"Sections 410A of the Medicare Modernization Act of 2003 as amended by sections 3123 and 10313 of the Affordable Care Act, section 15003 of the 21st Century Cures Act, and Consolidated Appropriations Act of 2021","Description":"The Rural Community Hospital Demonstration is testing the feasibility and advisability of providing reasonable cost reimbursements for small rural hospitals.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,CO,IA,KS,ME,MS,NE,OK,SD,WY","Keywords":"Statutory Models, Rural Community Hospital Demonstration, Medicare, rural","URL":"\/initiatives\/rural-community-hospital-demonstration","Display Model Summary":"TRUE","Unique ID":"67"},{"Model Name":"State Innovation Models Initiative: Model Design Awards Round One","Stage":"Not Active","Number of Participants":"16","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Sixteen states received funding to develop state-based models for multi-payer payment and health care delivery system transformation.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"OH,DE,HI,RI,TX,CA,IA,ID,TN,MD,CT,NH,PA,UT,MI,IL","Keywords":"State Innovation Models Initiative, State Innovation Models Initiative: Model Design Awards, State Innovation Models Initiative: Model Design Awards Round One, State \u0026 Community-Based Models, SIM Model Design Awards: Round One","URL":"\/initiatives\/State-Innovations-Model-Design\/","Display Model Summary":"TRUE","Unique ID":"68"},{"Model Name":"State Innovation Models Initiative: Model Design Awards Round Two","Stage":"Not Active","Number of Participants":"21","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The second round of State Innovation Models Initiative Model Design Awards provided financial and technical support to states for their planning and design efforts.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AS,AZ,CA,DC,HI,KY,IL,MD,MT,NV,NH,NJ,NM,MP,OK,PA,PR,UT,VA,WV,WI","Keywords":"State Innovation Models Initiative, State Innovation Models Initiative: Model Design Awards Round Two, State \u0026 Community-Based Models, SIM Model Design Awards: Round Two","URL":"\/initiatives\/State-Innovations-Model-Design-Round-Two\/","Display Model Summary":"TRUE","Unique ID":"69"},{"Model Name":"State Innovation Models Initiative: Model Pre-Test Awards","Stage":"Not Active","Number of Participants":"3","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Three states further developed their state-based models for multi-payer payment reform and health care delivery system transformation.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CO,NY,WA","Keywords":"State \u0026 Community-Based Models, State Innovation Models Initiative: Model Pre-Testing Awards, State Innovation Models Initiative, SIM Pre-Test Awards","URL":"\/initiatives\/State-Innovations-Model-Pre-Testing\/","Display Model Summary":"TRUE","Unique ID":"70"},{"Model Name":"State Innovation Models Initiative: Model Test Awards Round One","Stage":"Not Active","Number of Participants":"6","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"Six states implemented, tested, and evaluated a multi-payer health system transformation model that aimed to deliver high quality care and improve health system performance for its residents.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR,ME,MA,MN,OR,VT","Keywords":"State Innovation Models Initiative, State Innovation Models Initiative: Model Test Awards, State \u0026 Community-Based Models, SIM Test Awards: Round One","URL":"\/initiatives\/State-Innovations-Model-Testing\/","Display Model Summary":"TRUE","Unique ID":"71"},{"Model Name":"State Innovation Models Initiative: Model Test Awards Round Two","Stage":"Not Active","Number of Participants":"11","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The second round of State Innovation Models Initiative Model Testing Awards will provide financial and technical support over a four-year period for states to test and evaluate multi-payer health system transformation models.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CO,CT,DE,ID,IA,MI,NY,OH,RI,TN,WA","Keywords":"State Innovation Models Initiative, State Innovation Models Initiative: Model Test Awards, State \u0026 Community-Based Models, SIM Test Awards: Round Twoe","URL":"\/innovation-models\/state-innovations-round-two","Display Model Summary":"TRUE","Unique ID":"72"},{"Model Name":"State Innovation Models Initiative: Round One","Stage":"Not Active","Number of Participants":"25","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The first round of the State Innovation Models Initiative awarded nearly $300 million to 25 states to design or test innovative health care payment and service delivery models.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR,CA,CO,CT,DE,IA,ID,IL,MA,ME,MD,MI,MN,NH,NY,OH,OR,PA,RI,TN,TX,UT,VT,WA","Keywords":"State Innovation Models Initiative: Round One, SIM, State \u0026 Community-Based Models","URL":"\/initiatives\/State-Innovations-Round-One\/","Display Model Summary":"TRUE","Unique ID":"73"},{"Model Name":"State Innovation Models Initiative: Round Two","Stage":"Not Active","Number of Participants":"32","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The second round of State Innovation Models Initiative awards is providing over $665 million to support state-led, multi-payer health care payment and service delivery innovation.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AS,AZ,CA,CO,CT,DC,DE,IA,ID,IL,KY,MD,MI,MP,MT,NH,NM,NJ,NV,NY,OH,OK,PA,PR,RI,TN,UT,VA,WA,WI,WV","Keywords":"State Innovation Models Initiative, State Innovation Models Initiative: Round Two, State \u0026 Community-Based Models, SIM Round Two","URL":"\/initiatives\/State-Innovations-Round-Two\/","Display Model Summary":"TRUE","Unique ID":"74"},{"Model Name":"Strong Start for Mothers and Newborns Initiative: Effort to Reduce Early Elective Deliveries","Stage":"Not Active","Number of Participants":"","Category":"Health Plan Models","Authority":"Section 1115A of the Social Security Act","Description":"The Strong Start effort to reduce early elective deliveries supported providers and mothers-to-be in their efforts to decrease the number of early elective deliveries and improve outcomes for mothers and infants.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Strong Start for Mothers and Newborns Initiative, Health Plan Models, Medicaid, Children\u0027s Health Insurance Program (CHIP), Partnership for Patients","URL":"\/initiatives\/Strong-Start-Strategy-1\/","Display Model Summary":"FALSE","Unique ID":"75"},{"Model Name":"Strong Start for Mothers and Newborns Initiative: Enhanced Prenatal Care Models","Stage":"Not Active","Number of Participants":"182","Category":"Health Plan Models","Authority":"Section 1115A of the Social Security Act","Description":"This initiative tested three evidence-based maternity care service approaches that aimed to improve the health outcomes of pregnant women and newborns.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,AL,AR,AZ,CA,CT,DC,FL,GA,IL,KY,LA,MD,MI,MN,MO,MS,MT,NC,NE,NJ,NM,NV,NY,OK,OR,PA,PR,SC,TN,TX,VA,WI,WV","Keywords":"Strong Start for Mothers and Newborns Initiative, Health Plan Models, Medicaid, Children\u0027s Health Insurance Program (CHIP)","URL":"\/initiatives\/Strong-Start-Strategy-2\/","Display Model Summary":"TRUE","Unique ID":"76"},{"Model Name":"Transforming Clinical Practice Initiative","Stage":"Not Active","Number of Participants":"41","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"A large-scale health transformation initiative that supported clinician practices in sharing, adapting and developing comprehensive quality improvement strategies.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AK,AL,AR,AZ,CA,CO,CT,DE,FL,GA,HI,IA,ID,IL,IN,KS,KY,LA,MA,ME,MD,MI,MN,MO,MS,MT,NC,ND,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WA,WI,WV,WY","Keywords":"State \u0026 Community-Based Models, Primary Care Transformation, Transforming Clinical Practice Initiative, TCPI, quality improvement strategies, clinicians, learning networks, population-based care, large-scale investment, value-based payment, infrastructure","URL":"\/initiatives\/Transforming-Clinical-Practices\/","Display Model Summary":"TRUE","Unique ID":"77"},{"Model Name":"Value in Opioid Use Disorder 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Summary":"TRUE","Unique ID":"78"},{"Model Name":"Vermont All-Payer ACO Model","Stage":"Active","Number of Participants":"1","Category":"State \u0026 Community-Based Models, Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"This alternative payment model incentivizes delivery of health care value and quality among significant Vermont payers to transform health care for Vermont\u0027s population.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"VT","Keywords":"State \u0026 Community-Based Models, Accountable Care, Vermont All-Payer ACO Model, Medicare, Medicaid, all payer, VT All-Payer ACO Model","URL":"\/initiatives\/vermont-all-payer-aco-model\/","Display Model Summary":"TRUE","Unique ID":"79"},{"Model Name":"Innovation Advisors Program","Stage":"Not Active","Number of Participants":"71","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"The Innovation Advisors Program began in December 2011 when the Center selected 75 individuals from 920 applicants. Of these, 73 accepted from 27 States and the District of Columbia. During 2012 these individuals participated in activities to deepen key skill sets related to CMS strategy, population health and care redesign.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Innovation Advisors Program, Statutory Models","URL":"\/innovation-models\/innovation-advisors-program","Display Model Summary":"TRUE","Unique ID":"80"},{"Model Name":"Making Care Primary (MCP) Model","Stage":"Not Active","Number of Participants":"117 participants, 681 practices","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"A voluntary, primary care model that sought to improve care management, equip primary care clinicians to form partnerships with healthcare specialists and leverage community-based connections to address health-related social needs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"CO,MA,MN,NM,NJ,NY,NC,WA","Keywords":"Making Care Primary (MCP) Model, MCP Model, Accountable Care Models, primary care, Medicare, specialists, health related social needs, HRSN, Fee-for-Service, FFS","URL":"\/innovation-models\/making-care-primary","Display Model Summary":"TRUE","Unique ID":"82"},{"Model Name":"GUIDE (Guiding an Improved Dementia Experience) Model","Stage":"Active","Number of Participants":"320","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The GUIDE Model focused on dementia care management and aims to improve quality of life for people living with dementia, reduce strain on their unpaid caregivers, and enable people living with dementia to remain in their homes and communities.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,IA,ID,IL,IN,KS,KY,LA,MA,MD,ME,MI,MN,MO,MT,NC,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,TN,TX,UT,VA,WA,WI,WY,WV","Keywords":"Guiding an Improved Dementia Experience (GUIDE) Model, GUIDE Model, dementia, caregivers, education, support, care management, voluntary models, Medicare Part A, Medicare Part B, Medicaid, respite services","URL":"\/innovation-models\/guide","Display Model Summary":"TRUE","Unique ID":"83"},{"Model Name":"AHEAD (Achieving Healthcare Efficiency through Accountable Design) Model","Stage":"Active","Number of Participants":"6 states","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"AHEAD is a voluntary state total cost of care model with a goal of improving the total health of a participating state\u2019s population, reducing disparities in health care outcomes, and limiting the growth of health care costs.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"MD, CT, HI, VT, NY, RI","Keywords":"Accountable Care, Multi-Payer aligment, state selection, eligibility, All-Payer, efficiency hospital global budgets, primary care, AHEAD","URL":"\/innovation-models\/ahead","Display Model Summary":"TRUE","Unique ID":"84"},{"Model Name":"TMaH (Transforming Maternal Health) Model","Stage":"Active","Number of Participants":"15 states","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"TMaH focuses on improving maternal health outcomes for Medicaid and Children\u0027s Health Insurance Program (CHIP) enrollees. TMaH supports the development of a whole-person approach to pregnancy while reducing access and treatment disparities.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Transforming Maternal Health (TMaH) Model, State \u0026 Community-Based Models, Pregnancy, maternal health, maternity, childbirth, delivery, postpartum care, mothers, babies, Medicaid, Children\u0027s Health Insurance Program (CHIP), equity, disparities, social needs, newborns, TMaH, tmah","URL":"\/innovation-models\/transforming-maternal-health-tmah-model","Display Model Summary":"TRUE","Unique ID":"85"},{"Model Name":"IBH (Innovation in Behavioral Health) Model","Stage":"Active","Number of Participants":"4 (Michigan, New York, Oklahoma, and South Carolina)","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"IBH is a voluntary state model for Medicare\/Medicaid populations with mental health conditions and\/or substance use disorders. IBH aims to improve behavioral\/physical health outcomes and overall quality of care for this population.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Innovation in Behavioral Health (IBH) Model, IBH Model, Behavioral health, substance use disorders, SUD, Opioid Use Disorder, OUD, Medicaid","URL":"\/innovation-models\/innovation-behavioral-health-ibh-model","Display Model Summary":"TRUE","Unique ID":"86"},{"Model Name":"CGT (Cell and Gene Therapy Access) Model","Stage":"Active","Number of Participants":"35","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"The CGT Access Model is a voluntary model for states and manufacturers that tests whether a CMS-led approach to developing and administering outcomes-based agreements for cell and gene therapies improves access to innovative treatment.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"AR, AZ, CA, CT, CO, DC, DE, FL, IL, KS, KY, LA, MD, ME, MI, MO, MS, NC, NJ, NY, OH, OK, OR, PA, PR, RI, SC, TN, TX, UT, VT, WI, WV, VA, WA","Keywords":"Cell and Gene Therapy (CGT) Access Model, Sickle Cell Disease, Medicaid Drug Rebate Program","URL":"\/innovation-models\/cgt","Display Model Summary":"TRUE","Unique ID":"89"},{"Model Name":"ACO Primary Care Flex Model","Stage":"Active","Number of Participants":"23","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"The ACO Primary Care Flex Model is a voluntary model focused on improving funding and other resources to support primary care delivery in the Medicare Shared Savings Program. ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Organizations, ACOs, Primary Care, ACO PC Flex Model, ACO Primary Care Flex Model","URL":"\/innovation-models\/aco-primary-care-flex-model","Display Model Summary":"TRUE","Unique ID":"90"},{"Model Name":"TEAM (Transforming Episode Accountability) Model","Stage":"Active","Number of Participants":"721","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"TEAM is a five-year mandatory episode-based alternative payment model that incentivizes coordination between care providers during a surgery as well as the services provided during the 30 days that follow.  ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Transforming Episode Accountability Model (TEAM), healthcare innovation, innovation models, episode-based, mandatory models, care coordination, surgical and post-surgical care, acute care","URL":"\/innovation-models\/team-model","Display Model Summary":"TRUE","Unique ID":"91"},{"Model Name":"IOTA (Increasing Organ Transplant Access) Model","Stage":"Active","Number of Participants":"103 kidney transplant hospitals","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"The Increasing Organ Transplant Model is a mandatory model that aims to increase access to life-saving transplants for patients living with kidney disease.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Increasing Organ Transplant Access (IOTA) Model, Organs, Transplants, proposed, mandatory model, life-saving transplants, patients, chronnic kidney disease (CKD)","URL":"\/innovation-models\/iota","Display Model Summary":"TRUE","Unique ID":"92"},{"Model Name":"Medicare Two Dollar Drug List Model","Stage":"Not Active","Number of Participants":"N\/A","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"Medicare $2 Drug List Model (M2DL) was a proposed model to lower precription drug costs for people with Medicare.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Medicare Two Dollar Drug List Model, Medicare $2 Drug List Model, M2DL, precription drugs, Part D, generic prescription drugs, chronic conditions, copayments","URL":"\/innovation-models\/medicare-two-dollar-drug-list-model","Display Model Summary":"TRUE","Unique ID":"93"},{"Model Name":"Treatment of Certain Complex Diagnostic Laboratory Tests","Stage":"Not Active","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 3113 of the Affordable Care Act","Description":"This demonstration was mandated to direct separate payments to laboratories performing certain complex laboratory tests billed with a date of service that would, under standard Medicare rules be bundled into the payment to the hospital, or critical access hospital.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Treatment of Certain Complex Diagnostic Laboratory Tests, Medicare, laboratory testing, Critical Access Hospitals (CAH)","URL":"\/innovation-models\/medicare-demonstrations\/treatment-of-certain-complex-diagnostic-laboratory-tests","Display Model Summary":"TRUE","Unique ID":"94"},{"Model Name":"Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT)","Stage":"Active","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"","Description":"The RSNAT Model uses prior authorization to reduce ambulance transports that do not meet the Medicare criteria. The goal is to test whether prior authorization can decrease Medicare expenditures without affecting beneficiaries\u2019 access to or quality of care. ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT), RSNAT, RSNAT Model, ambulance, ambulance transport, Medicare, prior authorization","URL":"\/data-research\/monitoring-programs\/medicare-fee-service-compliance-programs\/prior-authorization-and-pre-claim-review-initiatives\/prior-authorization-repetitive-scheduled-non-emergent-ambulance-transport-rsnat#timeline","Display Model Summary":"TRUE","Unique ID":"95"},{"Model Name":"ACO Track 1 Plus Model","Stage":"Not Active","Number of Participants":"","Category":"Accountable Care Models","Authority":"","Description":"CMS Innovation Center Model designed based on feedback from stakeholders for options to facilitate Accountable Care Organizations\u2019 (ACOs\u2019) transition to performance-based risk, and to lower the levels of risk available to qualifying physician-only ACOs and\/or ACOs that include small rural hospitals. ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"ACO Track 1 Plus Model, ACO Track One Plus Model, ACO Track 1+ Model, Accountable Care Organization, rural","URL":"\/innovation-models\/aco","Display Model Summary":"TRUE","Unique ID":"96"},{"Model Name":"Medicare Prior Authorization Model for Non-emergent Hyperbaric Oxygen","Stage":"Not Active","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"This model tested CMS\u0027 belief that prior authorization would help to confirm that services provided were in compliance with applicable Medicare coverage, coding, and payment rules before services are rendered and claims are paid.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Medicare Prior Authorization Model for Non-emergent Hyperbaric Oxygen, prior authorization, HBO, Medicare","URL":"\/files\/document\/prior-authorization-non-emergent-hyperbaric-oxygen.pdf","Display Model Summary":"TRUE","Unique ID":"97"},{"Model Name":"WISeR (Wasteful and Inappropriate Service Reduction) Model ","Stage":"Active","Number of Participants":"6","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model uses enhanced technologies to streamline the review process for certain items and services that are vulnerable to fraud, waste and abuse, helping people with Medicare receive safe and appropriate care and protecting federal taxpayers.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"NJ, OH, OK, TX, AZ, WA","Keywords":"WISeR, Wasteful and  Innapropriate Service Redusction Model, fraud, abuse, waste, Medicare, sade and appropriate care, protecting federal taxpayers","URL":"\/innovation-models\/wiser","Display Model Summary":"TRUE","Unique ID":"98"},{"Model Name":"ASM (Ambulatory Specialty Model)","Stage":"Announced","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to improve prevention and upstream management of chronic disease, leading to reductions of avoidable hospitalization and unnecessary procedures.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"ASM (Ambulatory Specialty Model), ambulatiry care, heart failure, low back pain, avoidable hospitalization, chronic disease, Medicare","URL":"\/innovation-models\/asm","Display Model Summary":"TRUE","Unique ID":"99"},{"Model Name":"GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"This model aims to ensure fair and reasonable drug prices for Medicaid through CMS-led negotiations with drug manufacturers. ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Prescription drugs, negotiation, Medicaid, GENErating cost Reductions fOr U.S. (GENEROUS) Model","URL":"\/innovation-models\/generous","Display Model Summary":"TRUE","Unique ID":"100"},{"Model Name":"ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model","Stage":"Announced","Number of Participants":"","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"This model tests an outcome-aligned payment approach in Original Medicare to expand access to new technology-supported care options that help people improve their health and prevent and manage chronic disease.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, outcome-aligned payment, Medicare, technology, chronic disease, prevention, diabetes, blood pressure, chronic musculoskeletal pain, depression","URL":"\/innovation-models\/access","Display Model Summary":"TRUE","Unique ID":"101"},{"Model Name":"MAHA ELEVATE (Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence) Model","Stage":"Announced","Number of Participants":"","Category":"Statutory Demonstrations and Other Projects","Authority":"Section 1115A of the Social Security Act","Description":"The MAHA Model will provide approximately $100 million to fund 3-year cooperative agreements for up to 30 proposals that promote health and prevention for Original Medicare beneficiaries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Make America Healthy Again, MAHA, Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence, ELEVATE, chronic disease","URL":"\/innovation-models\/maha-elevate","Display Model Summary":"TRUE","Unique ID":"102"},{"Model Name":"Long-term Enhanced ACO Design (LEAD) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Accountable Care Models","Authority":"Section 1115A of the Social Security Act","Description":"Newest ACO-focused model to help a broad range of health care providers participate in ACOs, including smaller, independent and rural-based practices. ","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Accountable Care Organizations, ACOs, Primary Care, Long-term Enhanced ACO Design (LEAD) Model, LEAD, Enhancing Oncology Model, EOM, ACO REACH Model","URL":"\/innovation-models\/lead","Display Model Summary":"TRUE","Unique ID":"104"},{"Model Name":"GUARD (Guarding U.S. Medicare Against Rising Drug Costs) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"The GUARD Model is a proposed mandatory model that would assess rebates for certain drugs payable under Medicare Part D if the prices exceed those paid in economically comparable countries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Prescription Drug Pricing, Medicare Part B, out-of-pocket drug costs, quality of care, GUARD Model, Guarding U.S. Medicare Against Rising Drug Costs Model","URL":"\/innovation-models\/guard","Display Model Summary":"TRUE","Unique ID":"105"},{"Model Name":"GLOBE (Global Benchmark for Efficient Drug Pricing) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"The Global Benchmark for Efficient Drug Pricing (GLOBE) Model is a proposed mandatory model that would assess a rebate for certain drugs payable under Medicare Part B if the prices exceed those paid in economically comparable countries.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Prescription Drug Pricing, Medicare Part B, out-of-pocket drug costs, quality of care, GLOBE Model, Global Benchmark for Efficient Drug Pricing Model","URL":"\/innovation-models\/globe","Display Model Summary":"TRUE","Unique ID":"106"},{"Model Name":"BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Prescription Drug Models","Authority":"Section 1115A of the Social Security Act","Description":"The BALANCE Model aims to increase access to select GLP-1 medications and healthy lifestyle interventions \u2014 to help people with Medicare and Medicaid improve their health.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model, BALANCE Model, nutrition, Medicare, Medicaid, GLP-1, Part D, prescription drugs, prevention","URL":"\/innovation-models\/balance","Display Model Summary":"TRUE","Unique ID":"107"},{"Model Name":"ASPIRE (Accelerating State Pediatric Innovation Readiness and Effectiveness) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"State \u0026 Community-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"ASPIRE aims to facilitate coordinated care for children and youth with medically and\/or behaviorally complex conditions (high-risk) and children and youth with one or more risk factors for developing a complex condition (rising risk) who are covered by Medicaid and CHIP.","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"ASPIRE (Accelerating State Pediatric Innovation Readiness and Effectiveness) Model, ASPIRE Model, Medicaid, pediatric, children, youth, high-risk, rising-risk, CHIP","URL":"\/innovation-models\/aspire","Display Model Summary":"TRUE","Unique ID":"108"},{"Model Name":"CJR-X (Comprehensive Care for Joint Replacement Expanded) Model","Stage":"Announced","Number of Participants":"N\/A","Category":"Disease-Specific \u0026 Episode-Based Models","Authority":"Section 1115A of the Social Security Act","Description":"CJR-X would be the first nationwide test of a mandatory episode-based payment model. The CJR Model, which ended on December 31, 2024, was tested in 34 Metropolitan Statistical Areas (MSAs).","Number of Beneficiaries Impacted":"","Number of Physicians Impacted":"","Date Began":"","Date Ended":"","States":"","Keywords":"Comprehensive Care for Joint Replacement Expanded Model, CJR-X Model, Disease-Specific \u0026 Episode-Based Models, lower extremity joint replacement, hip replacement, knee replacement, surgeries, CJR Model","URL":"\/innovation-models\/cjr-x","Display Model Summary":"TRUE","Unique ID":"109"}]