Members' resource · Paid tier
Policy cartography · August 2026

CMS stopped writing rules and started building a market.

One year after the White House health tech event, CMS runs an app store, an identity layer, a provider directory, a network certification, and a technology challenge. None of it is a regulation. Underneath sits a payment book that moves money toward longitudinal relationships and puts two-sided risk on individual specialists. This is the map, and the read.

29Mechanisms mapped across five CMS instruments
60% → 80%Americans who can pull records into an app of choice; CMS's year-one number and its October target
800+Organizations that have signed a Health Tech Ecosystem pledge
−16.6%Proposed CY2027 work-RVU cut to total knee arthroplasty
Sep 4 · 14QualTech proposals close, then CY2027 fee schedule comments
What is inside

Five instruments, one direction

CMS is running five distinct machines at once. They are not coordinated on paper, and they point the same way. The full map opens every node with the mechanism, the dates, and the operator read.

1 · Pledge apparatus

  • Interoperability Framework
  • CMS Aligned Networks
  • Kill the Clipboard
  • Medicare App Library
  • National Provider Directory
  • Eight new categories
6 mechanisms

2 · Quality & QualTech

  • CCSQ QualTech
  • Digital quality measures
  • THA/TKA PRO-PM
  • MIPS sunset → MVPs
  • Equity measures removed
5 mechanisms

3 · The CY2027 rules

  • Two-track conversion factor
  • Efficiency adjustment
  • Arthroplasty RVU cuts
  • Software as a Medical Service
  • RPM/RTM restructuring
  • Inpatient-only phase-out
  • Prior auth APIs
7 mechanisms

4 · Model portfolio

  • ACCESS Model
  • CJR-X
  • TEAM
  • Ambulatory Specialty Model
  • WISeR
  • LEAD replaces ACO REACH
6 mechanisms

5 · The access layer

  • Modern scheduling
  • Digital identity
  • Conversational AI assistants
  • Annual Wellness Visit gap
  • Real-time benefits & price
5 mechanisms
Public record

Thirteen months, abridged

The dated record is open to everyone. The full map carries the complete timeline with source links, plus the mechanism brief behind each entry.

The members' room

The read is behind the gate

The public preview above is the record. What follows is the analysis: what each mechanism actually does, who it moves money toward, and where the room is.

Paid subscribers

The CMS Health Tech Map

One interactive board. Select any of the twenty-nine nodes for the mechanism, the dates, and a plain operator read on what it means for you.

Members29 mechanism briefsEvery node opens with what it does, the dates that bind, and the strategic consequence. Proposed is labeled proposed.
MembersDual-lens SWOTThe same facts from two chairs. Toggle between a health technology company and a hospital, and watch the conclusions invert.
MembersNine ranked white spacesScored on yield against crowding, organized around the thesis that CMS is buying outcomes and buying software plus services rather than licenses.
MembersFive places not to goNegative white space. Where CMS has moved against the business model and a 2024 roadmap quietly stops working.
MembersThe operating calendarNine decision points from September 4 through January 2029, each one a choice rather than a news item.
MembersTwenty primary sourcesCMS, the Federal Register, CMMI model pages, ASTP and the eCQI Resource Center. Every claim traceable.