CMS Innovation Center 2021 Strategy Refresh: Putting All Patients at the Center of Care
In 2021, the CMS Innovation Center, took stock of lessons learned from its first decade and 50+ models, charted a path for the next ten years of value-based care — one that would improve the health system for all patients.
CMS Innovation Center's Vision: A health system that achieved optimal outcomes through high quality, affordable, person-centered care.
The resulting strategy refresh drove our delivery system toward meaningful transformation, including paying for health care based on value to the patient instead of the volume of services provided, and delivered person-centered care that met people where they were.
CMS Innovation Center’s Strategic Objectives
The following strategic objectives guided the CMS Innovation Center’s implementation of its vision:
- Drive Accountable Care
Aim: Increased the number of beneficiaries in a care relationship with accountability for quality and total cost of care.
Accountable care reduces fragmentation in patient care and cost by giving providers the incentives and tools to deliver high-quality, coordinated, team-based care. Models should have increased the number of beneficiaries in accountable care relationships with providers, such as advanced primary care providers and ACOs. Quality of care and outcome measures should have been measures that matter and included patient values and perspective.
Measuring Progress:
- All Medicare fee-for-service beneficiaries would have been in a care relationship with accountability for quality and total cost of care by 2030
- The vast majority of Medicaid beneficiaries would have been in a care relationship with accountability for quality and total cost of care by 2030
- Support Care Innovations
Aim: Leveraged a range of supports that enabled integrated, person-centered care - such as actionable, practice-specific data, technology, dissemination of best practices, peer-to-peer learning collaboratives, and payment flexibilities.
The CMS Innovation Center tested approaches to close care gaps and deliver whole-person care by driving progress in areas like integrated care, behavioral health and social determinants of health. Work in this pillar also included leveraging data, technology, and payment flexibilities to enable care in homes & communities.
Measuring Progress:
- Set targets that improved performance of model participants on patient experience measures, such as health and functional status, or a subset of Consumer Assessment of Healthcare Providers and Systems (CAHPS®, a registered trademark of the Agency for Healthcare Research and Quality) measures that assessed health promotion and education, shared decision-making, and care coordination
- All models considered or included patient-reported outcomes as part of the performance measurement strategy for the CMS Innovation Center
- Improve Access by Addressing Affordability
Aim: Pursued strategies to address health care prices, affordability, and reduce unnecessary or duplicative care.
The CMS Innovation Center pursued strategies to address health care prices, affordability, and reduce waste. It sought to address affordability directly, such as through models that waived cost-sharing for high-value services or focused on moderating drug prices, as well as indirectly, and through models that targeted low-value care and sources of waste that drove up patient costs and proved challenging to confront in prior primary care-based models.
Measuring Progress:
- Set targets to reduce the percentage of beneficiaries that forego care due to cost by 2030
- All models considered and included opportunities to improve affordability of high-value care for beneficiaries
- Partner to Achieve System Transformation
Aim: Aligned priorities and policies across CMS and aggressively engaged payers, purchasers states, and beneficiaries to improve quality, to achieve optimal outcomes, to reduce health care costs.
The CMS Innovation Center could not achieve health transformation alone. It required working across CMS and the entire federal government, as well as working hand-in-hand with health care teams and payers, purchasers, states, providers, patient advocates and patients. Success hinged on multi-payer alignment on clinical tools, outcome measures, payment, and policy approaches and building the capacity to transform health care.
Measuring Progress:
- Where applicable, all new models would make multi-payer alignment available by 2030
- All new models would collect and integrate patient perspectives across the life cycle
Transformation Initiative
In 2023, the CMS Innovation Center conducted a retrospective review of select models to assess care delivery changes to help inform a new framework to accelerate transformation. The framework aimed to more systematically evaluate care delivery strategies that supported transformation for providers and patients and would disseminate best practices so that all Americans could access effective, person-centered care.
Learn more: Transformation Initiative At-a-Glance (PDF)
Originally posted on: May 12, 2025