Total cost of care models, like Connecticut AHEAD, include multiple components to bring healthcare providers and payers into aligned strategies to build high-quality, affordable and accountable service delivery networks in communities. Let's break it down into the basic concepts:
- Hospital Global Budgets: Voluntary participation in a hospital global budget provides a stable, predictable source of revenue for a hospital based on prior expenditures. Hospital global budgets feature safeguards and adjustments for social risk, quality and other factors and promote a focus on care coordination and outcomes.
- Primary Care AHEAD: Voluntary participation in Primary Care AHEAD provides primary care practices with prospective, flexible and enhanced payments intended to increase their capacity to deliver advanced primary care services. Model Payments will fund care transformation in care coordination, behavioral health integration and health-related social needs interventions.
- Population Health Accountability Plan: Connecticut will develop a statewide Population Health Accountability Plan to help prioritize community-driven strategies for improving population health by focusing on preventive care and chronic disease prevention.
- Geo AHEAD: Geo AHEAD will engage otherwise unattributed Medicare beneficiaries in value-based care and provide a new way to integrate total cost of care accountability across hospital global budgets and Primary Care AHEAD.
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