Maryland, Connecticut, and Vermont have been selected to participate in the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. Hawaii is also being considered, pending meeting certain requirements. The selected states will receive up to $12 million over the initial five and half years of the model.
The total-cost-of-care model seeks to “curb health care cost growth, improve population health, and advance health equity by reducing disparities in health outcomes.” Participating states will have the authority to manage health care costs and quality across all payers including Medicare, Medicaid, and private coverage with a focus on primary care and prevention activities.
This first cohort of states enter a pre-implementation period that runs from July 2024 to December 2025. The first performance year will be CY 2026 and will continue through December 2034. Their efforts will build upon work each state has already begun.
CMS will select up to four additional states to participate this fall. More information on AHEAD is available on the Center for Medicare and Medicaid Innovations (CMMI) website.