States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model
Agency: Centers for Medicare & Medicaid Services
Posted: 2023-11-16 | Closing date: 2024-08-12
Cohort 3: August 12, 2024, 3:00 pm Eastern Standard Time
Estimated total program funding: 96000000
Award ceiling: 12000000
Award floor: 0
Expected number of awards: 8
Cost sharing or matching requirement: No

This Notice of Funding Opportunity (NOFO) is announcing the opportunity to apply to participate in the States Advancing All-Payer Health Equity Approaches and Development Model (referred to as “AHEAD” or the “AHEAD Model”), including availability of Cooperative Agreement funding of up to $12 million per award recipient. State Medicaid agencies, state public health agencies, and other state agencies may apply to participate in AHEAD on behalf of their states.The AHEAD Model is a voluntary, state-based alternative payment and service delivery model designed to curb health care cost growth, improve population health, and advance health equity by reducing disparities in health outcomes. The AHEAD Model will test a flexible framework that includes statewide or sub-state accountability targets for all-payer and Medicare fee-for-service cost growth, primary care investment, and equity and population health outcomes. The Model will include specific components to help each award recipient to achieve these goals, including an initial investment via the Cooperative Agreement award to support planning and implementation activities, Medicare fee-for-service and Medicaid hospital global budgets for participating hospitals, and a primary care program for participating primary care practices.The AHEAD Model will operate for 11 years (2024-2034). Applicants must select one of three Cohorts to participate in based on their stage of readiness to implement the Model. CMS will select, via a competitive process, up to eight award recipients. Up to $12 million in Cooperative Agreement award funding will be available to each selected award recipient over the course of up to six years. The Model will conclude for all Cohorts on December 31, 2034.

Eligibility: Eligible applicants are state agencies (e.g., SMA, state public health agency, state insurance agency or other entity with rate-setting or budget authority) with the authority and capacity to accept the Cooperative Agreement award funding. Agencies may apply as a joint application on behalf of several state agencies, however, only one agency can accept the Cooperative Agreement and serve as the award recipient. The SMA must be included as a subrecipient of the Cooperative Agreement if it is not the award recipient. Eligible applicants are all 50 states, Washington, D.C., and U.S. territories that have at least 10,000 resident Medicare FFS beneficiaries enrolled in Medicare Parts A and B residing in the state or sub-state region based on the most recent data available from CMS Medicare Monthly Enrollment data. U.S. territories include American Samoa, Guam, Northern Mariana Islands, U.S. Virgin Islands, and Puerto Rico. Applicants may select to participate at the state level or designate a sub-state region, subject to CMS approval during the application review. Award recipients may have the ability to expand the sub-state region during the Pre-Implementation Period subject to approval by CMS. Approval of such requests are not guaranteed. States in which Making Care Primary Model (MCP) is operating on a statewide basis may not participate in AHEAD. If MCP is operating in a sub-state region of a state, that state would be eligible to apply to participate in AHEAD in a different sub-state region with no geographic overlap.