CMS says it will axe primary care, other CMMI innovation models

Medical groups will see the early termination of several payment models from the Center for Medicare and Medicaid Innovation (CMMI), including two primary care-focused models, an end-stage renal disease (ESRD) model and a Maryland-specific program.

 

CMS made the announcement in a fact sheet issued March 12, saying it would sunset the models earlier than planned, with an end date of December 31, 2025, in order "to align with its statutory obligation and strategic goals."

 

The announcement comes after newly appointed CMS Administrator Robert Kennedy Jr. took the reins at the federal agency. Kennedy previously announced other changes within the agency, such as doing away with the public comment process during yearly rulemaking (subscription required).

 

The four CMMI models that will see an early end include the Primary Care First Model, which involved roughly 2,100 medical practices and was originally planned to proceed through calendar year 2026, and the Making Care Primary Model involving 117 practices in seven states (Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, New York, North Carolina and Washington). The Making Care Primary Model launched in 2024 and was originally planned to last more than 10 years.

 

The other two models that will see early termination are the ESRD Treatment Choices (ETC) Model and the Maryland Total Cost of Care. In the statement, CMS said that, for the ETC Model, it "will propose termination through rulemaking." It remains unclear whether the same process will apply to the other models.

 

"Participants should expect follow-up communication from their models with timelines, technical assistance and other information regarding the wind-down and close-out," the agency said.

 

It appears other value-based payment models will continue. The fact sheet highlighted the Medicare Shared Savings Program, linking to 2026 application information. The fact sheet also highlighted advanced primary care management codes (subscription required) that became active Jan. 1, 2025, after being approved in the final 2025 Medicare physician fee schedule.

 

The agency added that, despite the early end of the primary care models, "primary care remains a foundational component of the Center’s strategy. The early termination of Primary Care First and Making Care Primary does not signal a retreat from the Center’s support of primary care providers, but rather a need to focus on different approaches that are consistent with the CMS Innovation Center’s statutory mandate and produce savings."