CMS Announces All-Payer Model for States
On September 5, 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary, state total cost of care (TCOC) model, “the States Advancing All-Payer Health Equity Approaches and Development Model” (States Advancing AHEAD or AHEAD Model). The goal is to work with states using hospital global budgets (HGBs) to control healthcare cost increases; improve population health; and advance health equity in health outcomes.
Through this model, individual states will voluntarily apply to participate through the Notice of Funding Opportunity (NOFO), beginning in the fall of 2023. CMS will choose up to eight states to participate in the AHEAD Model, which include specific application requirements. These states will have the opportunity to receive up to $12 million from CMS to support state implementation. Eligible providers that are Medicare-enrolled and are in good standing may participate; and include primary care practices, hospitals (including acute care hospitals, critical access hospitals and rural emergency hospitals) and health systems within the selected states.
Overall, the AHEAD Model will operate for 11 years, from 2023 to 2034, and will provide agreement funding to selected states for up to 6 years to support their participation in the AHEAD Model. For more specifics regarding the AHEAD Model, refer to the Model Overview Factsheet.
