The Centers for Medicare & Medicaid Services’ (CMS) Innovation Center introduced several new models over the past year to test approaches aimed at improving health outcomes and reducing costs in Medicare and Medicaid. The BALANCE, GENEROUS, GLOBE, and GUARD models advance efforts to negotiate drug prices, with the goal of bringing U.S. drug spending in line with economically similar countries. The ACCESS, ASM, and MAHA ELEVATE models focus on improving management of chronic conditions that contribute to poor health outcomes and high health care costs by focusing on preventive care and strengthening care coordination. The LEAD model builds on prior accountable care organization model efforts through updates intended to attract providers who have historically been less likely to participate in these models.

This Policy Cheat Sheet provides states with a clear, at-a-glance reference for the new Innovation Center models. It details each model’s key features, including a brief description, target population, model participants, CMS’ intended outcomes, implications for Medicaid, and important dates.

Medicaid agencies may be particularly interested in BALANCE, GENEROUS, and LEAD — models that either allow or incorporate Medicaid participation. Agencies may also want to follow enrollment and results from the remaining models. While Innovation Center models often start in Medicare, lessons can inform future Medicaid model design and benefit coverage decisions and may signal emerging CMS priorities.

CHCS will update this summary as needed when relevant new Innovation Center models are released.