Lexology November 4, 2024
Sheppard Mullin Richter & Hampton LLP

On October 28, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced the latest states to participate in the voluntary state total cost of care (“TCOC”) model: the All-Payer Health Equity Approaches and Development (“AHEAD”) Model. The initiative aims to curb healthcare costs and improve population health by allowing states to assume responsibility for their own healthcare systems. Specifically, the program holds states accountable for meeting state-specific Medicare targets, reducing cost growth, primary care investment, and advancing health equity principles. As of August 2024, Maryland, Vermont, Connecticut, Hawai’i, Rhode Island, and five downstate counties of New York have been selected to implement AHEAD.

Program Overview

In September 2023, CMS unveiled AHEAD, a new, voluntary state TCOC model that seeks...

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Topics: CMS, Equity/SDOH, Govt Agencies, Healthcare System, Insurance, Payer, Payment Models, Provider, Value Based
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