Fresh Analysis of CMMI Value-Based Care Models Highlights Positive Impact and Areas for Improvement
A new Avalere Health analysis commissioned by the Healthcare Leadership Council (HLC) evaluates the performance of 18 Center for Medicare and Medicaid Innovation (CMMI/Center) payment models revealing opportunities to further improve patient outcomes and deliver savings. As the Administration seeks to advance government efficiency while continuing to strengthen value-based care, this report’s detailed scorecards demonstrate CMMI’s impact by assessing operations, cost-effectiveness, quality metrics, and public engagement for each model.
Key findings of the analysis, which can be accessed in full here, relay the complex challenges and opportunities of testing new payment and delivery models. They include:
- Financial Impact: While one-third of the models incurred substantial net losses, one-third showed negligible financial effects, and one-third delivered significant net savings.
- Quality Performance: Overall, four models demonstrated improved quality outcomes, three models showed marginal improvements, seven models yielded mixed quality results, and four models had no significant quality impact.
- Public Feedback: The report identifies key areas for enhancing stakeholder engagement, such as providing public listening sessions and soliciting input through formal notice and comment rulemaking.
“The U.S. healthcare landscape is large and dynamic, so it’s crucial to move beyond broad generalizations of delivery system innovations, especially temporary pilot programs,” said Maria Ghazal, President and CEO of HLC. “While some CMMI models faced challenges, others demonstrated clear success in advancing value-based care. As the Trump Administration guides the Center into a new era, this report provides actionable insights for future program design.”
Ghazal also emphasized the importance of deeper public-private partnerships: “For years, the best of the American healthcare system has been innovating and refining value-based care approaches to improve patient outcomes while reducing costs. We encourage CMS leadership to collaborate closely with the private sector and leverage our nation’s ingenuity to design and improve future CMMI models.”
HLC and its members remain committed to supporting federal initiatives that promote value-based care, emphasizing efficiency, cost reduction, care coordination, and improved population health. This Avalere Health analysis was shared with leaders on Capitol Hill, as well as relevant officials inside the Administration.
Published April 10, 2025
