The CMS Innovation Center is committed to making model data more easily available to stakeholders to advance transparency on model performance and to support external research and learning. In line with this commitment, the CMS Innovation Center is releasing model participant data for use in data analysis research projects.
These data files may be used as ‘finder files’ in combination with other requested Chronic Conditions Warehouse (CCW) files to isolate results to include (or not include as desired) entities, providers and or beneficiaries participating in specific models.
Each model has a set of up to three (3) files, one per participant type:
Data for each model will be updated the first month of each calendar quarter, unless the model has ended. Models which have ended are identified in the table below.
The quarterly file updates are full replacement files and contain data from the launch of each model to the current quarter. Note: Participating entities, providers and beneficiaries may frequently change due to time lags in updates by model participants to their provider lists and/or to changes in beneficiary attribution. As such, these files should not be considered fully complete or final until approximately 6-12 months after a model has ended.
Data files are available for the following models:
- ACO Realizing Equity, Access, and Community Health (REACH) Model - This model aims to improve the quality of care for people with Medicare through better care coordination, reaching and connecting health care providers and beneficiaries, including those beneficiaries who are underserved.
Note: The ACO REACH model was previously called the Global and Professional Direct Contracting (GPDC) model.
- Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model - This model supports healthcare providers who invest in practice innovation and care redesign to better coordinate care and reduce expenditures, while improving the quality of care.
- Comprehensive Care for Joint Replacement (CJR) - This model is designed to improve care for Medicare patients undergoing hip and knee replacements (also called lower extremity joint replacements or LEJR) performed in the inpatient or outpatient setting and for total ankle replacements performed in the inpatient setting.
- Comprehensive Primary Care Plus (CPC+) Model - This national advanced primary care medical home model aims to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation.
- Emergency Triage, Treat and Transport (ET3) Model - This model aims to improve quality and lower costs by reducing avoidable transports to hospital Emergency Departments and unnecessary hospitalizations following those transports.
- End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model - This model is intended to encourage greater use of home dialysis and kidney transplants for Medicare beneficiaries with ESRD, while reducing Medicare expenditures and preserving or enhancing the quality of care furnished to beneficiaries with ESRD.
- Home Health Value-Based Purchasing (HHVBP) Model - This model is designed to improve the quality and delivery of home health care services to Medicare beneficiaries. Specific goals include providing incentives for better quality care with greater efficiency, studying new potential quality and efficiency measures for appropriateness in the home health setting, and enhancing the public reporting process. The HHVBP model data was included in the CMDS model participation data in a single submission for 2023 Q1. No new data will be available for this model for future CMDS quarterly releases.
- Independence At Home (IAH) Demonstration - Under this model, the CMS Innovation Center works with medical practices to test the effectiveness of delivering comprehensive primary care services at home and to determine if doing so improves care for Medicare beneficiaries with multiple chronic conditions. Additionally, the Demonstration rewards health care providers that provide high quality care while reducing costs.
- Kidney Care Choices (KCC) Model - This model helps health care providers reduce the cost and improve the quality of care for patients with late-stage chronic kidney disease and ESRD and aims to delay the need for dialysis and encourage kidney transplantation.
- Maryland Total Cost of Care (MDTCOC) - CMS and the state of Maryland are partnering to test the model, which sets a per capita limit on Medicare total cost of care in Maryland. The MDTCOC Model is the first Center for Medicare and Medicaid Innovation (Innovation Center) model to hold a state fully at risk for the total cost of care for Medicare beneficiaries.
- Oncology Care Model (OCM) - In this model, physician practices enter into payment arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients. The OCM model has ended and does not have new data for 2023 Q1 forward.
- Primary Care First (PCF) Model - This voluntary alternative five-year payment model rewards value and quality by using an innovative payment structure to support the delivery of advanced primary care.
- Value in Opioid Use Disorder Treatment (ViT) Demonstration Program - This is a four-year demonstration program authorized under section 1866F of the Social Security Act (Act), which was added by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). The purpose of the demonstration, as stated in the statute, is to “increase access of applicable beneficiaries to opioid use disorder treatment services, improve physical and mental health outcomes for such beneficiaries, and to the extent possible, reduce [Medicare program expenditures].”
- Vermont All-Payer Model (VTAPM) - This model is CMS’s test of an alternative payment model in which the most significant payers throughout the entire state – Medicare, Medicaid, and commercial health care payers – incentivize health care value and quality, with a focus on health outcomes, under the same payment structure for the majority of providers throughout the state’s care delivery system and transform health care for the entire state and its population.
The group of models for which CMDS participation files are available will expand over time to include additional models.
The model IDs for the 14 models in the CMDS file set is depicted in the table below.
|Model ID||Model Name||Short Name||Comments|
|63||ACO Realizing Equity, Access, and Community Health||ACO REACH||Previously titled GPDC|
|54||Bundled Payment for Care Improvement Advanced Model||BPCI-A|
|33||Comprehensive Care for Joint Replacement||CJR|
|22||Comprehensive Primary Care Plus Model||CPC+||Model Status: Ended. No new data for this model after Q4 2022.|
|65||Emergency Triage, Treat and Transport Model||ET3|
|64||ESRD Treatment Choices Model||ETC|
|37||Home Health Value-Based Purchasing Model||HHVBP||Q1 2023 is the only data submission|
|01||Independence At Home Demonstration||IAH|
|66||Kidney Care Choices||KCC|
|56||Maryland Total Cost of Care||MDTCOC|
|44||Oncology Care Model||OCM||Model Status: Ended. No new data for this model after Q4 2022.|
|57||Primary Care First||PCF|
|71||Value in Opioid Use Disorder Treatment Demonstration Program||ViT|
|53||Vermont All-Payer Model||VTAPM|
For further detail, please refer to the specific model website accessible through https://innovation.cms.gov/innovation-models#views=models.