Center for Medicare & Medicaid Innovation (CMMI)
The Center for Medicare & Medicaid Innovation (CMMI) is the CMS arm that designs and tests new payment and care-delivery models, such as bundled payments and accountable care arrangements. Its pilots shape how value-based reimbursement reaches surgery centers and other providers.
What is the Center for Medicare & Medicaid Innovation (CMMI)?
The Center for Medicare & Medicaid Innovation (CMMI) is the part of the Centers for Medicare and Medicaid Services (CMS) charged with developing and testing new ways to pay for and deliver care. Rather than relying solely on traditional fee-for-service billing, CMMI runs structured pilots that experiment with alternatives such as bundled payments, accountable care arrangements, and episode-based reimbursement.
These models are typically launched as time-limited demonstrations with defined participants and measurement criteria. Models that show they can improve quality or lower cost can be expanded or folded into broader Medicare policy.
Why does CMMI matter for surgery centers?
CMMI is one of the main engines pushing the healthcare system toward value-based reimbursement, where payment is tied to outcomes and efficiency rather than volume alone. The models it tests often become the template for how commercial payers later structure their own contracts.
For ambulatory surgery centers, CMMI initiatives like surgical bundles can directly reshape how a case is paid, packaging facility fees, implants, and follow-up care into a single negotiated amount. Understanding which models are active helps an ASC decide whether to participate and how to manage cost and documentation under those terms.
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