CMS Innovation Center 2021 Strategy Refresh: Putting All Patients at the Center of Care
In 2021, the CMS Innovation Center, having taken 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 will improve the health system for all patients.
CMS Innovation Center's Vision: A health system that achieves optimal outcomes through high quality, affordable, person-centered care.
The resulting strategy refresh drives 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 delivering person-centered care that meets people where they are.
CMS Innovation Center’s Strategic Objectives
The following strategic objectives will guide the CMS Innovation Center’s implementation of its vision:
- Drive Accountable Care
Aim: Increase 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 increase 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 be measures that matter and include patient values and perspective.
Measuring Progress:
- All Medicare fee-for-service beneficiaries will be in a care relationship with accountability for quality and total cost of care by 2030.
- The vast majority of Medicaid beneficiaries will be in a care relationship with accountability for quality and total cost of care by 2030.
- Support Care Innovations
Aim: Leverage a range of supports that enable 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 will test 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 includes leveraging data, technology, and payment flexibilities to enable care in homes & communities.
Measuring Progress:
- Set targets to improve 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 assess health promotion and education, shared decision-making, and care coordination.
- All models will consider or include patient-reported outcomes as part of the performance measurement strategy for the CMS Innovation Center.
- Improve Access by Addressing Affordability
Aim: Pursue strategies to address health care prices, affordability, and reduce unnecessary or duplicative care.
The CMS Innovation Center will pursue strategies to address health care prices, affordability, and reduce waste. It seeks to address affordability directly, such as through models that waive cost-sharing for high-value services or focus on moderating drug prices, as well as indirectly, and through models that target low-value care and sources of waste that drive up patient costs and have proven 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 will consider and include opportunities to improve affordability of high-value care for beneficiaries.
- Partner to Achieve System Transformation
Aim: Align priorities and policies across CMS and aggressively engage payers, purchasers states, and beneficiaries to improve quality, to achieve optimal outcomes, to reduce health care costs.
The CMS Innovation Center cannot achieve health transformation alone. It requires 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 hinges 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 will make multi-payer alignment available by 2030.
- All new models will 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 will aim to more systematically evaluate care delivery strategies that support transformation for providers and patients and to disseminate best practices so that all Americans can access effective, person-centered care.
Learn more: Transformation Initiative At-a-Glance (PDF)
Questions and Feedback
Submit questions or feedback on the strategy to CMMIStrategy@cms.hhs.gov. Also, sign up for the CMS Innovation Center listserv to receive regular updates about the CMS Innovation Center, including opportunities to participate in listening sessions about the strategy and updates on model tests.
Originally posted on: October 08, 2024 | Reviewed and revised on: February 26, 2025