What’s changing:
Today, the CMS Innovation Center announced changes to its model portfolio to align with its statutory obligation and strategic goals.
Innovation Center Models are time-limited experiments that provide a controlled environment to determine, through rigorous evaluation, what approaches should be expanded nationwide, what specific components of an approach need further testing in successor models and what approaches are not viable for expansion. As is the nature of innovation, not every model will work, and the Center must be efficient and effective in its response.
The Center regularly assesses and may amend model activities in response to a model’s projected savings, quality outcomes data, legal compliance, operational feasibility and gaps in expected versus actual impact.
The Center aims to end these models early, by December 31, 2025. Most models selected for early termination are within 2 years of their end date.
Models Identified to End Early (Original Performance Period)
- Maryland Total Cost of Care (2019 – 2026)
- Primary Care First (2021 – 2026)
- ESRD Treatment Choices (2021 – 2027; will propose termination through rulemaking)
- Making Care Primary (2024 – 2034)
CMS is considering options to reduce the size of the Integrated Care for Kids (2020 – 2026) awards or make other changes to the model.
Further, the CMS Innovation Center will no longer pursue two previously announced but not yet implemented models given the flexibility provided by President Trump’s rescission of Executive Order 14087 on January 20, 2025:
- Medicare $2 Drug List
- Accelerating Clinical Evidence
The CMS Innovation Center determined its other active models can meet the Center’s statutory mandate—either as is or with future modification—and therefore will continue moving forward.
Guiding evidence:
Based on an analysis of published evaluation reports and financial forecasting, CMS estimates a savings of almost $750,000,000 by ending the selected models early.
Support for participants and patients:
Participants should expect follow-up communication from their models with timelines, technical assistance and other information regarding the wind-down and close-out.
Additionally, the Center will support participants of ending models and advise those in state-specific total cost of care and primary care models of other regulatory options for advanced primary care payment.
Primary care remains a foundational component of the Center’s strategy. The early termination of Primary Care First and Making Care Primary does not signal a retreat from the Center’s support of primary care providers, but rather a need to focus on different approaches that are consistent with the CMS Innovation Center’s statutory mandate and produce savings.
Ending these models early offers the opportunity to get beneficiaries into more permanent programs to support their health and care.
The Innovation Center will publish final evaluation reports from ending models to inform participants and other stakeholders of the important findings and insights about the tested approaches to value-based care.
What to expect next:
The CMS Innovation Center will continue providing transparency about important changes to advance its mission to lower costs and improve quality of care.
The Center looks forward to sharing information about next steps, including its new strategic vision, modifications to models to improve their potential for certification and expansion and new models that empower Americans to live healthier lives while protecting taxpayers.
Additional resources:
- Statement on CMS Innovation Center Aligning Portfolio with Statutory Obligation
- Medicare Shared Savings Program Application – Application information for 2026
- Physician Fee Schedule - Advanced Primary Care Management Code – Bundles payments for many services tested by Innovation Center primary care models