CMS has selected a sub-state region in New York and Rhode Island to participate in cohort 3 of the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.
Six things to know:
1. State participants for all three cohorts are:
- Cohort 1: Maryland and Vermont
- Cohort 2: Connecticut and Hawaii
- Cohort 3: New York (in five downstate counties: Bronx, Kings, Queens, Richmond and Westchester) and Rhode Island
2. States selected to participate in AHEAD were required to select one of three cohorts depending on their readiness to implement the model:
- Cohort 1: 18 months, beginning January 2026, with nine performance years
- Cohort 2: 30 months, starting January 2027, with eight performance years
- Cohort 3: 24 months, also beginning January 2027, with eight performance years
3. Each participating state may receive up to $12 million from CMS for implementation activities over the first 5-6 years. The AHEAD model runs through 2034, allowing time for primary care investments and improved care coordination to achieve better health outcomes and cost savings.
4. Launched in September 2023, AHEAD is a voluntary, total cost of care initiative aiming to curb healthcare costs, improve population health and advance health equity by reducing health disparities. The model supports states through increased primary care investment, hospital financial stability and community resource connections.
5. The following models and programs can concurrently operate within an AHEAD state or sub-state region, with certain conditions and restrictions:
- ACO REACH
- Guiding an Improved Dementia Experience
- Primary Care First
- Innovation in Behavioral Health
- Medicare Shared Savings Programs
6. The following models cannot concurrently operate within the participating AHEAD state or sub-state region:
- Making Care Primary
- Transforming Maternal Health
Click here to learn more about the AHEAD model.