State Innovation Models Initiative: General Information

The State Innovation Models Initiative is providing support to states for the development and testing of state-based models for multi-payer payment and health care delivery system transformation with the aim of improving health system performance for residents of participating states. Nearly $300 million has been awarded to 25 states to design or test improvements to their public and private health payment and delivery systems. The projects will be broad based and focus on people enrolled in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).

CMS is launching Round Two of the State Innovation Models initiative to provide up to $730 million for continued support to existing Model Design states and partner with additional states to accelerate health transformation. View the Round Two Funding Opportunity Announcement (FOA) (PDF).

Round One Awards

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Round One Model Testing Awards

Over $250 million in Model Testing awards support six states that are implementing their State Health Care Innovation Plans. A State Health Care Innovation Plan is a proposal that describes a state’s strategy to use all of the levers available to it to transform its health care delivery system through multi-payer payment reform and other state-led initiatives.

Round Two Model Testing Awards information is now available.

Round One Model Pre-Test Awards

The three states that received Round One pre-testing assistance used the funding to continue to work on comprehensive State Health Care Innovation Plans.

Round One Model Design Awards

The 16 states that received Model Design funding produced a State Health Care Innovation Plan. States will use these Health Care Innovation Plans to apply for the second round of  Model Test or Design funding.

Round Two Model Design Awards information is now available.

Background

The Innovation Center created the State Innovation Models initiative for states that are prepared for or committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. The Innovation Center is interested in testing innovative payment and service delivery models that have the potential to lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), while maintaining or improving quality of care for program beneficiaries. The goal is to create multi-payer models with a broad mission to raise community health status and reduce long term health risks for beneficiaries of Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

The Round Two funding opportunity expands on lessons learned from Round One by focusing on parameters CMS believes correlate with successful state health delivery and payment system transformation. For example, Round Two requires state applicants to articulate a broad vision for state-wide health care transformation; describe ambitious, realizable programs in identified areas; commit to using the full range of regulatory, payment, and policy authorities available to facilitate transformation; and commit to sustain their model after the design and/or test period concludes. Additionally, states may propose a public private partnership that is focused on accelerating health system transformation, such as with a non-profit affiliated with the State Department of Health that could receive and administer funds through a Model Design or Model Test award.

Additional Information

For additional information, contact the State Innovation Models team at stateinnovations@cms.hhs.gov.



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