AHEAD Model

In March 2024, Vermont’s Agency of Human Services has applied to CMS to participate in the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, a new federal program that would allow Medicare to join Vermont’s health care reform efforts. The Model would begin in 2026 and replace Vermont’s All-Payer Model. The primary components of the model are:

• Hospital Global Budgets, where hospitals will be paid a fixed amount of revenue, or a “global budget,” to provide services to Medicare fee-for-service beneficiaries.
• Primary Care AHEAD, which is a voluntary program for primary care practices to receive an additional payment from Medicare to provide coordinated care to Vermonters with Medicare coverage.

Informational Materials

• VMS, AAP-VT & FTAFP comment letter regarding the Model
• AHS’ Website regarding the AHEAD Model.
• AHS presentation to the Green Mountain Care Board detailed slides describing the Model
• Read Vermont’s AHEAD Model application.
• AHS’ Health Reform Workgroup materials, including the Primary Care Workgroup materials –
• See slides from December 15^th cross-walking between the approximately $17 per FFS Medicare beneficiary payment that Medicare will make available to practices participating in the Model with Vermont’s existing Blueprint and ACO payments (slides 8-12)
• See slides from January 23rd (slides 11 & 12- link downloads slides), discussing primary care quality measures required by AHEAD.