CMS Accepting Applications for AHEAD Model

In November, the Centers for Medicare and Medicaid Services (CMS) announced a Notice of Funding Opportunity (NOFO) for the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.

The AHEAD Model is intended to cut costs for states and improve overall patient health while advancing health equity, according to the CMS Website. In Fall 2023, CMS released the NOFO for an application period in Spring 2024. CMS intends to award eight states model contracts over two application periods. State agencies like Medicaid programs or state public health agencies with the ability to accept federal funding are encouraged to apply.

The CMS AHEAD Model FAQ explains that the first application period opened on November 16 and closes March 18th for Cohort 1 and 2, with awardees announced in May 2024. The second application period (Cohort 3) will open on June 12 and close August 12, 2024. States will be selected based on a merit review of all applications using a detailed rubric for scoring.

Center for Medicare and Medicaid Innovation Director Liz Fowler told PolicyMed last year that the models are a part of a larger CMS effort to increase the number of specialists currently participating in value-based care. The model is expected to emulate the current partnership between CMS and the state of Maryland, which established a budget for state hospitals in order to incentivize lowering unnecessary hospitalizations.

Like the arrangement with Maryland, participants in the AHEAD Model will have hospitals participate in switching from being paid based on the number of patients served or services provided to a “global budget” under which the hospitals would receive a predetermined amount for all care for specific populations. KFF notes that states and hospitals must also develop their own equity plans with health equity tools that include adjusting payment rates for people based on social risk factors and providing bonus payments for hospitals that meet equity targets.