Improving Waiver and Program Flexibilities for Advanced Payment Models

Waivers and Flex Cover

Policy Brief

Improving Waiver and Program Flexibilities for Advanced Payment Models

Alternative payment models offered by the Center for Medicare and Medicaid Innovation often include regulatory waivers to encourage participation and drive beneficial care delivery transformation. By affording organizations regulatory relief from certain federal laws, waivers can promote value-based arrangements by reducing obstacles to delivering high-quality, integrated care. However, our analysis indicates that many organizations have not elected to utilize waivers despite the flexibilities offered. This brief considers why waiver flexibilities are underutilized and how waiver modifications can encourage broader adoption to support CMS’ continued effort to advance value-based payment models.

Duke-Margolis Affiliated Authors

William K. Bleser - Margolis headhot

William K. Bleser, PhD, MSPH

Assistant Research Director, Payment Reform and Population Health
Senior Team Member
Anti-Racism and Equity Committee Member

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Senior Team Member
Margolis Core Faculty