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The law established the Centers for Medicare and Medicaid Services (CMS), which conducts pilot demonstrations to test new ways of delivering care to patients. The Innovation Center develops new payment and service delivery models in accordance with the requirements of Section 1115A of the Social Security Act. Additionally, Congress has defined, through both the ACA and previous legislation, a number of specific demonstration projects to be conducted by CMS. This Center continues to search for existing and promising innovative programs that can be replicated or scaled up to improve the quality and safety of health care delivered, while also reducing the rate of growth in health care spending for Medicare, Medicaid, and the Children’s Health Insurance Program (https://innovation.cms.gov/innovation‐models/map#).

New and promising innovations occur in numerous states and are continually seeking additional participants. A few of the latest entrants include a variety of initiatives focused on Accountable Care Organizations (ACOs). For instance, one innovation is studying the quality and cost of providing Program of All‐Inclusive Care for the Elderly (PACE) program services under Medicare and Medicaid models of care. Another is working to improve kidney care choices and end‐stage renal disease (ESRD) models of care for Medicare recipients. Yet another demonstration provided incentive payment awards to participating nursing homes that perform the best or improve the most in terms of quality. Nurses and nursing care figure prominently in each of these demonstrations. Included in this provision, the Department of Health and Human Services (HHS) was required to submit a National Strategy for Quality Improvement in Health Care that would include these programs in addition to those of third‐party payers.