The New York State Department of Health (NYSDOH) today announced that the Centers for Medicare and Medicaid Services (CMS) selected New York State to participate in the new States Advancing All-Payer Equity Approaches and Development (AHEAD) Model.  This announcement was made via the following press release: New York State Department of Health Announces AHEAD Model to Transform more than $5 Billion in Healthcare Payments to More Equitable and Sustainable Delivery Systems.  The AHEAD Model aims to improve population health and advance health equity, while controlling health care cost growth.  New York State will receive $12 million in federal funding over six years to support model implementation.  This funding comes in addition to the $2.2 billion over three years that New York and CMS committed at the start of 2024 to stabilize and transform targeted financially distressed voluntary hospitals.  For more information about the AHEAD Model, please visit: https://www.cms.gov/priorities/innovation/innovation-models/ahead.

New York State Department of Health Announces AHEAD Model to Transform more than $5 Billion in Healthcare Payments to More Equitable and Sustainable Delivery Systems

Adds to New Investments in Safety Net Hospitals and Primary Care to Advance Equitable and High-Quality Care for New Yorkers

"Participation in the AHEAD Model will advance New York State's mission of achieving an equitable healthcare system for all Medicare, Medicaid, and commercially insured New Yorkers," State Health Commissioner Dr. James McDonald said.  "The innovative Model will transform more than $5 billion in healthcare payments to support hospitals and primary care providers in the downstate region through global budget initiatives and increased investments in advanced primary care."

Participation in the AHEAD Model will advance New York State's mission of achieving an equitable healthcare system for all Medicare, Medicaid, and commercially insured New Yorkers.  The innovative Model will transform more than $5 billion in healthcare payments to support hospitals and primary care providers in the downstate region through global budget initiatives and increased investments in advanced primary care.  The State will engage community stakeholders throughout AHEAD planning and implementation to support four key objectives:

• Improve overall population health
• Invest in access to quality primary care and healthcare
• 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

The AHEAD model will build upon New York's previous healthcare delivery system reform efforts and solidify New York's role as a leader in value-based care innovation and population health improvement.  Most recently through the Delivery System Reform Incentive Payment (DSRIP) initiative, New York achieved a 26.1% decrease in preventable admissions and converted 80% of its Medicaid Managed Care payments to value-based arrangements.  New York State also runs the largest state patient-centered medical home (PCMH) program in the country, with 2,000 practices and 9,000 providers serving 66% of Medicaid Managed Care Members.  Participation in the AHEAD Model complements existing widespread investments to advance health equity and reduce health disparities for New Yorkers.  At the start of 2024, CMS approved New York State's 1115 Waiver Amendment that directs more than $7.5 billion to support hospitals' transformation to global budgets, strengthen the healthcare workforce through new career pathway training and student loan repayment programs, and address HRSNs through the implementation of Social Care Networks (SCN) and the Statewide Health Equity Regional Organization (HERO).  For more information about the AHEAD Model, visit: https://www.cms.gov/priorities/innovation/innovation-models/ahead.