The Centers for Medicare & Medicaid Services (CMS) announced certain states have been selected to participate in the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Under cooperative agreements with CMS, each state will receive up to $12 million during the first six years of the 11-year model to support implementation.
The AHEAD Model introduces hospital global budgets for Medicare fee-for-service (FFS), Medicaid, and commercial payor spending and offers a voluntary payment enhancement program for primary care practices. Notably, participating hospitals will receive prospective, biweekly payments in place of traditional Medicare FFS claims payments—providing stable and predictable funding.
The selected states, announced on July 2, 2024, are as follows:
- Maryland
- Vermont
- Connecticut
- Hawaii, pending satisfaction of certain requirements
Selected states will begin a pre-implementation period in July 2024. Maryland and Vermont will participate in Cohort 1, which begins the first program year in January 2026; Connecticut will participate in Cohort 2, which will begin the first program year in January 2027. Hawaii’s cohort has not yet been announced.
Our previous article provides additional details about the AHEAD Model’s goals, eligibility, model overlap issues, funding mechanisms, data collection and performance metrics, and the program timeline.
Next Steps
CMS will issue up to four additional cooperative agreements later this year. State agencies interested in applying for Cohort 3 are encouraged to submit a letter of intent by July 26, 2024. Electronic applications for the third and final cohort are due on August 12, 2024, at 3:00 p.m. ET.
We’re Here to Help
Contact your Moss Adams professional for help navigating the program, including planning for receiving AHEAD Model payments, operational planning, quality reporting, and assistance with other compliance requirements.
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