Model Categories and Stages

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 Demonstrations and Other Projects:

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

Stages

• Announced:

  Model has been publicly announced.

• Active:

  Model is in its performance period or evaluation is ongoing.

• 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• Withdrawn: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.