CMS Announces New Model for Community and Rural Health Access

Situation Report | August 24, 2020

The U.S. Centers for Medicare and Medicaid Services (CMS) has announced a new Community Health Access and Rural Transformation (CHART) model to: financially stabilize rural providers through up-front, outcomes-based investments; remove regulatory barriers; and implement other sustainability measures that allow additional services for social determinants of health, food and housing.

CHART will test whether upfront investments, predictable capitated payments, and operational and regulatory flexibilities will enable rural health care providers to improve access to high quality care while reducing health care costs.

Rural Health Transformation and Innovation

CMS is providing funding for rural communities to build systems of care through a Community Transformation Track and is enabling providers to participate in value-based payment models where they are paid for quality and outcomes, instead of volume, through an Accountable Care Organizations (ACO) Transformation Track.

Community Transformation Track

CMS will select up to 15 Lead Organizations for this track. A Lead Organization is a single entity that represents a rural community. Examples include state Medicaid agencies, State Offices of Rural Health, local public health departments, Independent Practice Associations, and Academic Medical Centers.

Lead Organizations will be responsible for working closely with key model participants (e.g., including participant hospitals and the state Medicaid agency) to implement Transformation Plans with their community partners. CMS confirmed on a national outreach call on August 18 that home health and hospice can be partners under this track.

Lead Organizations and their community partners will receive upfront cooperative agreement funding, financial flexibilities through a predictable capitated payment amount (CPA) for participant hospitals in a community, and operational and regulatory flexibilities.

ACO Transformation Track

CMS will also select up to 20 rural-focused ACOs to receive advanced payments as part of joining the Medicare Shared Savings Program.

More information is here.