The Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a slate of models focused on specialty care efficiencies, chronic disease management, and the increase of evidence-based service recommendations. Key models include:

• Ambulatory Specialty Model (ASM): Proposed in July’s 2026 Physician Fee Schedule, ASM would mandate specialist accountability for chronic heart failure and low back pain care across selected regions. By rewarding prevention and coordination with primary care, it aims to reduce avoidable hospitalizations and “low-value” procedures.
• Increasing Organ Transplant Access (IOTA) Model: Launched July 1, 2025, IOTA is a six-year mandatory model incentivizing kidney transplant hospitals to perform more transplants while improving patient outcomes. Hospitals face bonuses or penalties based on transplant volume, organ offer acceptance rates, and post-transplant quality. The goal is to save lives by closing the gap between organ supply and demand and addressing disparities in access.
• Transforming Episode Accountability Model (TEAM): Starting January 2026, TEAM is a mandatory bundled payment model for certain surgeries (like joint replacements and cardiac bypass). Hospitals in selected regions will be accountable for cost and quality from surgery through 30 days post-discharge. Notably, participants must connect patients to primary care after surgery to support recovery and long-term health.
• Radiation Oncology (RO) Model: CMS has signaled plans to resurrect this episode-based model to bundle 90-day radiotherapy episodes with site-neutral, value-based payments. (The RO Model’s implementation had been delayed, indicating ongoing refinements before launch.)
• Wasteful and Inappropriate Service Reduction (WISeR) Model: Announced in June 2025, WISeR (launching 2026) enlists technology companies to streamline Medicare’s prior authorization using AI. These tech participants will review high-risk, low-value services (e.g. certain skin substitutes, spinal stimulators) to curb unnecessary care.They earn a share of savings from averted waste, aligning innovation with cost control.

This new wave of models signals a strategic pivot by CMS toward technology-driven oversight and patient education. By guiding specialists and hospitals into value-based arrangements, CMS hopes to improve outcomes (fewer complications, better chronic care) and cut costs from fraud or low-value services.

For more information about the CMS Innovation Models, please visit https://www.cms.gov/priorities/innovation/models.