NY Selected to Participate in CMS AHEAD Model
(Nov. 4, 2024) NYS will receive $12 million in federal funding over six years to support the implementation of the Centers for Medicare and Medicaid Services (CMS) All-Payer Health Equity Approaches and Development (AHEAD) Model. The AHEAD Model promises to transform more than $5 billion in health care payments to support hospitals and primary care providers in five downstate counties – Bronx, Kings, Queens, Richmond, and Westchester – through global budget initiatives and increased investments in advanced primary care.
NY’s participation in the AHEAD Model will satisfy a requirement of the State’s Medicaid 1115 Waiver to implement a hospital global budget model to support financially distressed safety net hospitals. The AHEAD funding is in addition to the $2.2 billion provided under the waiver over three years to stabilize and transform targeted certain financially distressed voluntary hospitals.
The AHEAD Model is a voluntary, total cost of care (TCOC) model that involves all payers: Medicare, Medicaid, and commercial health plans. Under the AHEAD Model, CMS and the State will work collaboratively to curb health care cost growth, improve population health through investments in primary care, and advance health equity by addressing disparities in health outcomes.
The State has committed to engage community stakeholders throughout AHEAD implementation to support four key objectives:
- Improve overall population health
- Invest in access to quality primary care and health care
- Enable financial stability and predictability for hospital systems, including safety net providers
- Advance health equity by ensuring referrals to health-related social needs (HRSN) services
After a 24-month pre-implementation period, the model is expected to be in place through 2034. More information is available here.
Contact: Karen Lipson, klipson@leadingageny.org