"Though many models have been tested, only a few have clearly emerged as successful at reducing costs and improving outcomes," according to the center's 2022 report to Congress. Six models led to statistically significant savings:

Pioneer ACO;
ACO investment;
Medicare prior authorization: repetitive scheduled non-emergent ambulance transport;
Home health value-based purchasing;
Maryland all-payer; and
Medicare care choices.

The Pioneer ACO and Medicare care choices models also showed significant improvements in care quality. An additional four models led to gross, but not net, savings:

Comprehensive care for joint replacement;
Comprehensive end-stage renal disease care;
Oncology care; and
Million hearts: cardiovascular disease risk reduction.

CMS estimates that during the period of this report, more than 41.4 million Medicare and Medicaid beneficiaries and individuals with private insurance in multi-payer model tests have been affected by, have received care from or will soon be receiving care furnished by the more than 314,000 health care providers and/or plans participating in the CMS Innovation Center payment and service delivery models and initiatives. Because a number of these programs, models and initiatives involve multiple payers or focus on broad areas of quality improvement, millions of other Americans are benefiting from the CMS Innovation Center's activities.

Instant Insights /

Six value-added payment approaches evaluated by CMS result in significant savings

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