Evaluations & Research Reports

Evaluations & Research Reports

All CMS Innovation Center Models are rigorously and independently evaluated. Best practices and lessons learned from evaluation reports are often used to inform the next iterations of model tests.

Get more information about how CMMI conducts model evaluations, including the difference between model participant financial results and model evaluation spending results.

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Find evaluation reports for CMS Innovation Center models by browsing or searching below. Individual CMMI model pages also contain evaluation reports (search models).

 

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Results 1-10 of 359

Maternal Opioid Misuse (MOM) Model - Fourth Annual Evaluation Report (PDF)

July 2025

The Maternal Opioid Misuse (MOM) Model provides integrated care for pregnant/postpartum Medicaid beneficiaries with OUD. Through the third year of implementation, seven states engaged 2,119 patients using peer recovery services, provider communication improvements, and Health Related Social Needs resource connections. As the MOM Model ends in December 2025, states are designing sustainable funding and expanding access by broadening populations served, opening new clinics, and training providers.Read more

Primary Care First Model Options - Third Evaluation Report

May 2025

In its third performance year, PCF had no meaningful effect on hospitalizations and an increase in Medicare expenditures, as expected at this point in the model. Practices remained engaged in the model and continued to implement, and often modified existing care delivery strategies, especially care management, and added new strategies focused on comprehensiveness of and access to care.Read more

Preview of Findings from the Evaluation of ACO REACH Model for Performance Year 2023

May 2025

This document comprises a summary of performance year (PY) 2023 findings that will be included in the forthcoming evaluation report for ACO REACH. This report offers evaluation findings that informed the PY 2026 model design changes for ACO REACH. Building on the evaluation findings from the Global and Professional Direct Contracting Model in PY 2022, this summary of the forthcoming evaluation report indicates increased net spending associated with the ACO REACH Model cumulatively, although the PY 2023 results also show signs trending in a positive direction overall for gross savings, quality, and utilization measures.Read more

Evaluation of the Kidney Care Choices (KCC) Model: Summary of Findings for the Second Performance Year

May 2025

The Kidney Care Choices (KCC) Model includes two model options: the Kidney Care First (KCF) option primarily uses payment adjustments, and the Comprehensive Kidney Care Contracting (CKCC) option is a total cost of care model with varying levels of risk. Results from the second year (PY2023) of the KCC Model continued to show significant improvements in key quality goals of the model, such as increased rates of home dialysis and home dialysis training, increased optimal starts to dialysis, and increased preemptive and living donor transplants. Despite these quality gains, the model resulted in a significant net loss to Medicare in PY2023.Read more

BPCI Advanced Sixth Annual Report

April 2025

The BPCI Advanced Model produced savings of $346 million in Model Year 5 (2022), driven largely by decreases in post-acute care spending. This finding continues the pattern of savings in Model Year 4 (2021), after CMS made changes to the model that were designed to increase the likelihood of savings to Medicare following losses in Model Years 1-3. This report describes how participants achieved savings while maintaining quality on claims-based outcomes (readmissions and mortality), but identifies room for improvement in patient-reported care experiences and satisfaction. Read more

Independence at Home: Year Nine Evaluation Report

March 2025

The Independence at Home (IAH) Demonstration was launched in 2012 through Section 3024 of the Patient Protection and Affordable Care Act. Under the demonstration, physician- and nurse-led teams provide primary care services in the homes of beneficiaries with chronic illness and functional limitations. IAH practices receive a payment incentive if they generate savings above an established threshold and meet quality-of-care targets. This evaluation report covers the first nine years of the demonstration and examines the IAH incentive payment’s effects on spending, utilization, and quality during 2022, the third year of the COVID-19 pandemic.Read more

Medicare Advantage Value-Based Insurance Design Model Evaluation Report: 2020 to 2023 (PDF)

March 2025

Participation in VBID General has increased substantially since Phase II of the model test began, in part due to statutory expansion of the model nationwide and opening participation to special needs plans. Reduced cost sharing for Part D and supplemental benefits dominated VBID General offerings in 2023. VBID General is associated with increases in beneficiary drug adherence, risk scores, and inpatient stays in 2020 and 2021, and Star Ratings and costs to CMS in 2021 and 2022. VBID Hospice participation continued to grow, but uptake of model services continued to be low in 2023.Read more

Medicare Diabetes Prevention Program (MDPP) Expanded Model Final Annual Evaluation Report

March 2025

During the first six years of the program (April 2018-March 2024), MDPP suppliers enrolled just over 9,000 beneficiaries, with about half being in Medicare Advantage and the other half in traditional fee-for-service Medicare.  More than half of beneficiaries met the 5% weight loss goal. Among those who lost at least 5% of body weight and stayed in the program, over 80% maintained or lost additional weight by the end of the program.  MDPP beneficiaries are satisfied with the program and have reported short-term benefits such as improvements in body fat, cholesterol, and A1c levels.  However, effects on population health are limited given low program enrollment.Read more

Emergency Triage, Treat, and Transport (ET3) Model - Final Evaluation Report (PDF)

January 2025

During its three-year duration, less than 40% of the model’s 185 participant ambulance suppliers and providers delivered any Transport to Alternative Destination (TAD) or Treatment In Place (TIP) ET3 interventions because of implementation challenges. TIP made up nearly all of the 3,418 ET3 interventions delivered (>90 percent). TIP recipients had a higher risk of subsequent emergency department (ED) visits or hospitalizations within 5 days compared to referent group episodes. Participant organizations that delivered at least 100 ET3 interventions during the model exhibited a lower risk of subsequent ED visits or hospitalizations than participants with fewer than 100 ET3 interventions.Read more

State Innovation Models Initiatives - Final Summary Report (PDF)

January 2025

The CMS Innovation Center awarded funding to 17 awardees across two rounds of the State Innovation Model (SIM) that operated between 2013-2020. This paper summarizes qualitative and quantitative findings to expand the evidence base for state-based models including the role states can play in spreading value-based payment, policy and implementation lessons learned, and the relevance of these findings for successive Innovation Center models.Read more

Results 1-10 of 359

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04/30/2025 10:40 AM