CMS Innovation Center Pushes for More Mandatory Payment Models

Officials say mandatory models are needed to drive more providers into value-based care

Published on Mar. 4, 2026

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The CMS Innovation Center (CMMI) is exploring more mandatory payment models as a way to get more healthcare providers, especially poor-performing ones, to participate in value-based care, according to CMMI Director Abe Sutton and CMS Administrator Dr. Mehmet Oz. The officials said mandatory models will have to be part of the equation to overcome the healthcare industry's historical wariness of taking on financial risk.

Why it matters

Mandatory payment models are controversial, as providers have been reluctant to be forced into value-based arrangements that require them to take on financial risk. However, voluntary models have struggled with issues like risk adjustment, where high-performing providers tend to stay in the models while lower-performing ones drop out. The CMMI is pushing for more mandatory models as a way to drive broader adoption of value-based care and address the healthcare system's continued reliance on fee-for-service payment.

The details

The CMMI proposed three mandatory models in 2025, the highest number in a single year and one-third of all the models proposed. One model is focused on improving chronic disease prevention by incentivizing specialists to coordinate better with primary care doctors, while two more are focused on reducing drug costs. The CMMI has been increasing its use of mandatory models under both the Trump and Biden administrations, as the healthcare industry remains largely entrenched in fee-for-service payment structures despite years of efforts to shift to value-based care.

  • The CMMI started trialing more mandatory models during the first Trump administration, a direction that continued under President Joe Biden.
  • The CMMI proposed three mandatory models in 2025, the highest number in a single year.

The players

Abe Sutton

Director of the CMS Innovation Center (CMMI).

Dr. Mehmet Oz

Administrator of the Centers for Medicare & Medicaid Services (CMS).

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What they’re saying

“Mandatory models are going to have to be part of the equation.”

— Abe Sutton, Director, CMS Innovation Center (Accountable for Health conference)

“Why hasn't [value-based care] grown faster?”

— Dr. Mehmet Oz, Administrator, Centers for Medicare & Medicaid Services (Accountable Care for Health event)

What’s next

The CMMI is expected to continue proposing more mandatory payment models as it seeks to drive broader adoption of value-based care across the healthcare system.

The takeaway

The CMMI's push for mandatory payment models highlights the ongoing challenges in transitioning the healthcare industry away from fee-for-service reimbursement, as providers have historically been reluctant to take on financial risk. However, the CMMI believes mandatory models are necessary to overcome this resistance and accelerate the shift to value-based care.