Innovation Insights
Get a quick snapshot of Innovation Center activities to advance our strategy and support evidence-based prevention, patient empowerment, and greater choice and competition.
Apply Now for MAHA ELEVATE to Build a Healthier America
March 13, 2026
What's new: CMS invites organizations committed to supporting people to build healthier lives with evidence-based, whole-person functional or lifestyle medicine interventions to apply for the MAHA ELEVATE Model; CMS will award up to thirty 3-year cooperative agreements up to a combined total of $100 million to implement programs that enhance conventional health care.
Affordability of GLP-1s Takes Next Step with BALANCE Model RFAs
March 9, 2026
What's new: State Medicaid agencies and Medicare Part D plan sponsors are now encouraged to apply to participate in the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model, which will lower the cost and expand coverage of select GLP-1 medications for weight management in Medicare Part D and Medicaid.
CMS’ AHC Model Connects People to Community Resources and Generates $200 Million in Savings
February 17, 2026
What’s new: The AHC Model’s final evaluation report shows that the model generated over $200 million in net savings by screening over 1.1 million people with Medicare and Medicaid for five “core needs”— housing instability, food insecurity, transportation problems, utility difficulties and interpersonal violence—and connecting those who had higher-risk of developing complex...
Major Health Plans Join ACCESS Payer Pledge
February 12, 2026
What’s new: Major health payers representing 165 million Americans with Medicare Advantage, Medicaid and private health insurance plans pledged to adopt an outcomes-based payment structure aligned to the Medicare-focused ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model.
Comprehensive Care for Joint Replacement (CJR) Model Generates Savings to Medicare
December 3, 2025
What’s new: The CJR Model generated $112.7 million in savings to Medicare while maintaining quality for over 98,000 knee and hip replacement patients across 323 hospitals in 2021-2023, according to the model’s Performance year 7 Evaluation.
New Rapid Cycle Testing Sets Out to Identify Best Practices Earlier
November 28, 2025
What’s new: The CMS Innovation Center is launching the Rapid Cycle Innovation Program, partnering with model participants to administer rapid randomized controlled trials (RRCTs) that focus on real health outcomes; instead of just managing symptoms with care as usual, this initiative puts patients first, using an evidence-based approach to health by quickly identifying...
RFI Now Open for Comments on Potential Improvements to Medicare Advantage
November 25, 2025
What's new: CMS is seeking public input in a Request for Information (RFI) on how to improve and modernize Medicare Advantage (MA) — including changes to risk adjustment, quality bonus payment policies, and wellness and nutrition policies — through either a time-limited model test under the CMS Innovation Center’s authority or potential program-wide regulatory changes.
The Innovation in Behavioral Health (IBH) Model Integrates Physical and Mental Health to Power Prevention for States
November 12, 2025
What’s new: CMS is seeking additional states to take part in a whole-person, integrated care approach to mental health, substance use disorder, and physical health services for people with Medicaid and Medicare coverage, with the aim to comprehensively address root causes of health issues before they increase in severity.
CMS Announces Changes to AHEAD Model to Improve Quality, Promote Transparency, and Decrease Costs
September 2, 2025
What’s new: The CMS Innovation Center announced new policy and operational changes, as well as a new end date, to the Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model to help states achieve their total cost of care (TCOC) targets, while advancing the Center’s commitment to promote choice and competition, increase prevention, empower patients, and...
Model Participants Drive Value-Based Cancer Care
August 25, 2025
What’s new: First reconciliation results for the CMS Innovation Center’s Enhancing Oncology Model (EOM) showed cost savings for more than three quarters of participants; more than half were also rewarded for quality of care.
Proposed Changes Expand Reach of the Medicare Diabetes Prevention Program to Achieve MAHA Goals
August 5, 2025
What's new: CMS is proposing changes to the Medicare Diabetes Prevention Program (MDPP) to broaden the evidence-based program’s reach to more beneficiaries at risk for type 2 diabetes through an on-demand (asynchronous) online delivery option.
CMS Model Delivers Access to Sickle Cell Gene Therapy with Expansive List of State Participants
July 15, 2025
What’s new: 33 states, the District of Columbia, and Puerto Rico signed agreements with CMS to participate in the Cell and Gene Therapy (CGT) Access Model.
CMS Updates Accountable Care Model to Improve Model Sustainability
June 3, 2025
What’s new: The CMS Innovation Center is updating the ACO REACH Model, including its financial methodology, to ensure the accountable care pilot program can successfully achieve future cost savings.
CMS Fine-tunes and Extends Kidney Model to Rein in Spending
May 27, 2025
What’s new: The CMS Innovation Center is revising the financial methodology and participation options and extending the Kidney Care Choices (KCC) Model to help address early concerns about spending, while continuing quality improvements through 2027.
Page Last Modified:
03/13/2026 02:59 PM