The CMS Innovation Center released its new strategic direction on May 13, 2025, outlining an ambitious plan to “Make America Healthy Again” through value-based care transformation.
CMS believes the current healthcare system requires fundamental reform, citing larger trends: Medicaid consumes the largest portion of most state budgets, six in 10 Americans live with chronic disease, and the Medicare trust fund faces insolvency by 2036.
The Innovation Center’s plan attempts to address these systemic problems through coordinated changes to payment models and care delivery.
These priorities will increase healthcare price transparency and provide consumers with clear cost information so they can make informed decisions about their care.
Every initiative includes proposed safeguards for taxpayers: Providers must accept financial risk for poor outcomes, emphasize cost-effective care, and show they’re saving money.
Program Changes as a Result of CMS’s New Strategy
The CMS Innovation Center has articulated a clear mission and strategic vision to guide its value-based care initiatives. The overall strategy presents a framework that addresses healthcare’s major challenges, though specific implementation pathways still need to be developed. While the vision speaks broadly of transformation, empowerment, and cost reduction, organizations will need concrete operational guidance to translate these principles into practice across diverse care settings.
Shortly after this announcement, CMS released the ACO Reach model changes for PY2026. The ACO REACH changes represent one of the first concrete policy moves following the strategic announcement, demonstrating that CMS plans to implement its broader vision through existing programs.
Getting Ready for CMS’s New Direction
But while CMS has outlined ambitious goals like patient empowerment, the agency hasn’t yet specified whether or not payment methodologies will change to support provider investments in digital tools and infrastructure. As CMS continues to clarify implementation strategies, automation and information sharing will be critical.
Healthcare organizations can begin positioning themselves for success by focusing on three strategic priorities that align with the Innovation Center’s framework.
- Promote evidence-based prevention: Integrate preventive care alerts into clinical workflows to identify and address gaps in screenings, immunizations, and chronic disease management. Automated population health reporting can track preventive service utilization and stratify patients by risk. Integrating social determinants of health (SDOH) data with clinical and claims systems can create a more complete picture of patient risk and preventive care needs.
- Empower people to achieve health goals: Use digital tools and patient portals to engage individuals in goal setting, care planning, and self-management. Patient-facing platforms should allow individuals to report needs and track progress toward their health goals, including social determinants of health like housing and income stability.
- Drive choice and competition: Automate performance tracking to demonstrate quality, patient satisfaction, and value to consumers and payers. Support independent provider participation in value-based programs and promote transparent reporting that helps patients choose between providers and care options.
CMS’s Three-Part Approach to Healthcare Reform
The Innovation Center’s strategy aims to shift healthcare from a reactive treatment model to one that prevents illness, engages patients as active participants in their care, and creates competitive markets that reward high-quality, efficient providers.
The strategy supports the administration’s cost-cutting agenda (which includes substantial Medicaid spending reductions) by shifting financial risk to providers and requiring demonstrated savings in all payment models. The approach also emphasizes rural provider engagement and shapes program features to benefit rural healthcare delivery.
There are three main priorities in the new strategy:
- Promote evidence-based prevention: Embed preventive care across all payment models and measure health outcomes like days at home rather than just clinical metrics.
- Empower people to achieve their health goals: Provide patients with better access to health data, provider performance information, and digital tools for disease management.
- Drive choice and competition for people: Support independent provider participation in value-based programs and promote patient choice in coverage and care settings.
Keywell works with healthcare organizations to get their data and analytics ready for what’s coming from CMS. Contact us to start the conversation.
