CHA News

CMS Issues a Request for Information Related to Episodic Payment Models

This post has been archived and contains information that may be out of date.

On July 14, the Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) related to episodic payment models. In the RFI, CMS notes its interest in developing payment models that will create additional opportunities for specialists to participate in models that facilitate “accountable care relationships” with Medicare beneficiaries. The agency believes this step is necessary to achieve its goal of having 100% of Medicare beneficiaries in an accountable care relationship by 2030.  

The RFI requests information on questions related to “foundational components” of episodic payment models, including:  

  • Clinical episodes 
  • Participants 
  • Health equity 
  • Quality measures, interoperability, and multi-payer alignment 
  • Payment model and structure 
  • Overlap with other accountable care models 

CMS anticipates that responses to this RFI will inform a future mandatory episodic payment model that would begin “no earlier than 2026.”