TCOC

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On October 28, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced the latest states to participate in the voluntary state total cost of care (“TCOC”) model: the All-Payer Health Equity Approaches and Development (“AHEAD”) Model. The initiative aims to curb healthcare costs and improve population health by allowing states to assume responsibility for their own healthcare systems. Specifically, the program holds states accountable for meeting state-specific Medicare targets, reducing cost growth, primary care investment, and advancing health equity principles. As of August 2024, Maryland, Vermont, Connecticut, Hawai’i, Rhode Island, and five downstate counties of New York have been selected to implement AHEAD.  Continue Reading CMS Continues to Plan AHEAD Amid Rising Healthcare Costs

An April 2024 independent[1] report (“Report”) analyzed the results of the first four years following implementation of the Maryland Total Cost of Care Model (the “TCOC Model”), finding that between 2019 and 2022 (the “TCOC Measuring Period”), the TCOC Model reduced Medicare spending, hospital admissions, and health disparities. CMS also distributed a summary of the Report’s findings.Continue Reading Attention Maryland Providers: Are You Availing Yourselves of Regulatory Flexibilities under the TCOC Model?