CMS announces changes to AHEAD Model for states

Sep 03, 2025 - 03:24 PM
cms-nh-work-for-medicaid

The Centers for Medicare & Medicaid Services Innovation Center Sept. 2 announced changes to the Achieving Healthcare Efficiency through Accountable Design Model, including a new end date of Dec. 31, 2035. Other changes beginning in January 2026 include a requirement for states to implement at least two policies on promoting choice and competition in their health care markets, and the creation of a population health accountability plan on preventive care that includes chronic disease prevention. The AHEAD model is a total cost of care model designed to help states curb growth in health care costs and support those seeking to increase investments in primary care, provide financial stability for hospitals and support beneficiary connection to community resources.

Related News Articles

Headline
CMS releases updated report on complaint data, enforcement efforts 
The Centers for Medicare & Medicaid Services has released an updated report on complaint data and enforcement of health insurance market reforms. CMS said…
Headline
Survey finds 1 in 5 privately insured adults reported coverage denials for doctor-recommended care
A survey released June 4 by the Commonwealth Fund on insurance coverage denials found that 1 in 5 privately insured U.S. adults reported that they or a family…
Headline
House committee advances hospital billing legislation 
The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital…
Headline
Analysis finds Marketplace enrollment could fall by at least 17% in 2026
A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels…
Headline
CMS releases 2027 notice of benefit and payment parameters final rule
The Centers for Medicare & Medicaid Services May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and…
Headline
Blog details why Anthem policy limits access to care
A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why Anthem’s nonparticipating provider policy limits patients’ …