Big changes are hitting Medicare payment programs. The Centers for Medicare & Medicaid Services (CMS) just announced its shutting down four payment models years ahead of schedule. The reason? To save taxpayers nearly $750 million and refocus on strategies that actually work.
Gone by 2025:
- Maryland Total Cost of Care
- Primary Care First
- End-Stage Renal Disease Treatment Choices
- Making Care Primary
CMS isn’t just cutting programs—they’re shifting strategies. In a March 12 statement, the agency said these models either didn’t deliver enough savings, improve care quality, or were too clunky to run. The goal now? Focus on approaches that “prevent disease, empower patients, and drive competition.”
But there’s more. Two planned programs—the Medicare $2 Drug List (meant to slash prescription costs) and Accelerating Clinical Evidence (aimed at fast-tracking research into care)—got scrapped entirely. An executive order 14087 from January wiped out the legal push for these ideas, leaving them dead on arrival.
Even Medicare’s kid-focused program, Integrated Care for Kids, isn’t safe. CMS is rethinking its funding and structure, hinting at possible cuts.
The CMS Innovation Center admitted some models simply didn’t deliver. Savings fell short. Quality gains were meh. Paperwork drowned providers. Now, they’re pivoting to “what actually moves the needle”—preventing illness, not just treating it.
But here’s the twist: killing these programs isn’t about abandoning primary care. It’s a reboot. Officials claim winding down clunky models frees up cash and staff to launch better ones. Patients in axed programs? They’ll get funneled into “more permanent” setups—though details are fuzzy.
Doctors in these models will get exit kits—timelines, hotlines, and advice on switching to other payment options. Critics grumble about whiplash for clinics that retooled for Primary Care First. Supporters argue clinging to dud programs helps nobody.
The CMS Innovation Center promises a new playbook later this year: fewer Hail Mary experiments, more proven strategies. Think simpler rules, faster results, and models that actually stick around.
For now, the message is clear: Medicare’s payment system is no longer a sandbox. If your model can’t prove it’s worth the cash and the hassle? You’re out.
For full details, check CMS’s official announcement here.