
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

Jonathan Gonzalez-Smith, MPAff
Research Associate

William K. Bleser, PhD, MSPH
Assistant Research Director, Health Care Transformation for Population Health, Social Needs, and Health Equity
Senior Team Member
Anti-Racism and Equity Committee Member

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