The advent of cell and gene therapies has brought unprecedented breakthroughs in the field of medicine, offering hope for previously untreatable diseases. But while the science continues to rapidly advance, the question of how to ensure access and affordability for patients and the health care system has yet to be answered. In early 2023, the Centers for Medicare and Medicaid Innovation announced it will test a new financing approach for cell and gene therapies, under which states could assign CMS to negotiate multi-state, outcomes-based agreements for selected cell and gene therapies. In this session, stakeholders will discuss the key considerations for implementing such a model, and how this model could pave the way for additional experimentation by CMS and other payers.