09/07/2023
This sounds a lot like what we've been working toward, but only 8 states would get these grants.
'States have existing relationships with hospitals, primary care providers, payers, local government and communities, and non-profit organizations, which can be leveraged to improve population health and advance health equity. Under the AHEAD Model, participating states will take accountability for health care spending, population health, and health equity improvements. State participants will partner with hospitals and primary care practices to redesign care. Additionally, a primary role of states participating in the AHEAD Model will be to leverage existing relationships to recruit and partner with hospitals for purposes of the hospital global budgets — participating hospitals will receive a fixed payment amount in advance of a prospectively set budget per year.
'These payments would be for both Traditional Medicare and Medicaid, while other payers may also choose to pay participating hospitals based on a global budget for their enrolled populations or specific patient groups. Additionally, states will recruit primary care providers to participate in multi-payer primary care transformation, which will include increased investment by Traditional Medicare and an advanced primary care program aligned between Medicaid and Traditional Medicare. Other payers may also choose to align with this advanced primary care program by offering prospective care management payments, rewarding performance on aligned quality measures, and focusing provider efforts on behavioral health integration and addressing health-related social needs.'
Model aims to improve the overall health of a state population by ensuring providers are delivering efficient, high-quality, and coordinated care to patients
