Medicare is testing new ways to pay for medical services, emphasizing value rather than volume, and evidence is beginning to build about successes and challenges. This briefing examined what we know so far about the basic models, savings, quality, the impact on patients and the prospects for replication.

The Affordable Care Act established initiatives to develop and test these new approaches through the Center for Medicare and Medicaid Innovation (CMMI). The demonstration projects include patient-centered medical homes, accountable care organizations (ACOs), bundled payments and independence at home programs. Currently, these programs account for care provided to about 10 million Medicare beneficiaries.