The Centers for Medicare & Medicaid Services (CMS) is partnering with states to revamp regional healthcare delivery through the AHEAD Model, or the States Advancing All-Payer Health Equity Approaches and Development Model.

Participating states will have increased access to primary care services and lower healthcare costs for patients as well as put expenditures on a “more sustainable trajectory,” according to a news release. The model also includes payment streams for hospitals and primary care practices, while patients should be able to get more screenings and referrals to community resources like housing and transportation.

Health insurers will pay a fixed amount to participating hospitals, on top of traditional Medicare and Medicaid. Primary care providers will also be able to participate and offer care management payments.

“In our current health care system, fragmented care contributes to persistent, widening health disparities in underserved populations,” said CMS Administrator Chiquita Brooks-LaSure. “The AHEAD Model is a critical step towards addressing disparities in both health care and health equity while improving overall population health.”

“Primary care is the foundation of a high-performing health system and essential to improving health outcomes for patients and lowering health care costs,” said Deputy CMS Administrator and Innovation Center Director Liz Fowler, Ph.D. “For that reason, the CMS Innovation Center has invested significant time and resources over the years testing models to strengthen primary care and improve care coordination and linkages to organizations that address health-related social needs.”

CMS said the AHEAD Model was partially based on the Maryland Total Cost of Care Model, the Vermont All-Payer ACO Model and the Pennsylvania Rural Health Model.

Eight selected states could receive up to $12 million from CMS for model implementation. Three separate cohorts are available since some states may be more ready to implement the model than other states. Application requirements will be released in late fall. States will participate in the AHEAD Model as early as January 2026 to December 2034, while some states will be given pre-implementation access.

In August, CMS published new changes to the ACO REACH Model including reducing the beneficiary alignment minimum for entrant ACOs and expanding criteria to include more beneficiaries.