CMS Announces Updates to Dialysis Facility Compare: Patient Experience Ratings Now Available

By: Kate Goodrich, M.D., Director, Center for Clinical Standards and Quality

Today, the Centers for Medicare & Medicaid Services (CMS) announced changes to the Dialysis Facility Compare (DFC) website on Medicare.gov, which provides information about thousands of Medicare-certified dialysis facilities across the country, including how well those centers deliver care to patients.

These changes are in direct response to the important feedback CMS has received from dialysis patients and their caregivers about what is most important to them in selecting their dialysis facility. CMS remains committed to seeking and incorporating input from all stakeholders, but especially patients, on an ongoing basis so that we can continually improve our Compare sites and make health care quality information more transparent and understandable for patients and their caregivers.

Since the initial release of the Dialysis Facility Compare website, patients have emphasized in their feedback to CMS that understanding how others like them view a dialysis center— in particular the cleanliness of the facility and how well the staff cares for them— is valuable information when choosing a facility. As a result, visitors to the updated Dialysis Facility Compare website will now be able to see how patients rate their experiences with dialysis facilities.

CMS collects patient experience data though the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey, which measures patients’ perspectives on the care they received at dialysis facilities. A total of six ratings on patients’ experiences with care will be reported, including three that cover specific aspects of patient experience and three overall patient ratings of the kidney doctors, the facility staff and the dialysis facilities. For each dialysis center on Dialysis Facility Compare, the site will include this patient experience information, the quality star rating, and detailed clinical quality information.

CMS is also adding two quality measures to Dialysis Facility Compare:

  • The standardized infection ratio (SIR) is a ratio of the number of bloodstream infections that are observed at a facility versus the number of bloodstream infections that are predicted for that facility, based on national baseline data.
  • The pediatric peritoneal dialysis Kt/V measure equals the percent of eligible pediatric peritoneal dialysis patients at the facility who had enough waste removed from their blood during dialysis.

Other major changes to the site include modifications to the methodology for calculating dialysis facility star ratings based on recommendations from a 2015 Technical Expert Panel. The updated methodology for calculating star ratings:

  • Establishes a baseline to show improvement by taking into account year-to-year changes in facility performance on the quality measures compared to performance standards set in a baseline year. Star ratings will reflect if a facility improves (or declines) in performance over time.
  • Limits the impact of a few very low scores by applying a statistical method called truncated z-scores to percentage measures. This ensures that star ratings are not determined by extreme outlier performance on a single measure.
  • Ensures accuracy of ratings by keeping the continuity of the measures.

A final change to the DFC website relates to ratio measures:

  • The Standardized Mortality Ratio, Standardized hospitalization Ratio, Standardized Transfusion Ratio, and Standardized Readmission Ratio will now be reflected as rates to display them more clearly.

These changes reflect CMS’ ongoing commitment to making sure that Dialysis Facility Compare meets the needs of individuals with kidney disease and their caregivers. This Compare website and today’s updates are part of the agency’s larger effort to make health care quality information more transparent and understandable for consumers.  As part of that effort, CMS also has other Compare websites to help in selecting providers across the continuum of care, including Home Health Compare, Hospital Compare, Nursing Home Compare, and Physician Compare.

For more information, see the fact sheet: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-28.html 

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CMS Awards Special Innovation Projects to Quality Innovation Network-Quality Improvement Organizations Aimed to Drive Better Care, Smarter Spending, and Healthier People

By: Patrick Conway, MD, MSc
Acting Principal Deputy Administrator
Deputy Administrator for Innovation and Quality
CMS Chief Medical Officer

Kate Goodrich, MD
Director
Center for Clinical Standards and Quality

Dennis Wagner, MPA
Director, Quality Improvement and Innovation Group
Centers for Clinical Standards and Quality

The Centers for Medicare & Medicaid Services (CMS) has taken another step toward ensuring that beneficiaries receive better care, better value, and achieve better overall care, smarter spending, and healthier people by awarding 20, two-year Special Innovation Projects (SIPs) to 12 regional Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs). The SIPs offer QIN-QIOs and their partners, clinicians, schools of higher education, innovation labs, and Medicare beneficiaries and their families the opportunity to address critical health care issues important to their constituency in the areas of quality improvement that may be underutilized, but represent a significant opportunity if spread locally, regionally, or nationally. QIN-QIOs serve the Medicare population by working with Medicare beneficiaries, providers, and communities in data-driven initiatives that increase patient safety, make communities healthier, better coordinate post-hospital care, and improve clinical quality.  QIN-QIOs were eligible to submit proposals for two types of SIPs in 2016:

  1. Projects addressing issues of quality occurring within the QIN-QIOs’ local service area: “Advance Local Efforts for Better Care at Lower Cost.”
  2. Projects focusing on expanding the scope and national impact of quality improvement interventions that have proven success in limited areas or scope: “Interventions that are Ready for Spread and Scalability.”

Projects that “Advance Local Efforts for Better Care at Lower Cost” include:

  • Great Plains QIN will work with 25 home health agencies in Kansas, Nebraska, North Dakota, and South Dakota to develop and test educational interventions to prevent and manage common infections observed in home health such as respiratory, urinary tract and wound infections.
  • Health Services Advisory Group will be building capacity for telepsychiatry services in the Virgin Islands of St. Croix, St. John, and St. Thomas to address the lack of psychiatric specialty services available.
  • TMF Quality Innovation Network will be working with 80 physician practices in Arkansas, Missouri, Oklahoma, and Texas to increase primary care physician knowledge of treatment for depression and alcohol use disorder through knowledge transfer from specialists to primary care physicians.

Topic areas for “Interventions that are Ready for Spread and Scalability” were identified through consultation with the Strategic Innovation Engine (SIE). The Strategic Innovation Engine (SIE) is a new endeavor that will advance CMS’ six quality goals by rapidly moving innovative, evidence-based quality practices from research to implementation throughout the QIN-QIO program and be made available to the greater health care community. The SIE will serve as an instrument in furthering the science of improvement to better inform quality improvement efforts in the future for QIOs and others that draws upon the literature, healthcare quality data, and experts and practitioners in the field to ensure safe, effective practices are available for use by providers seeking to improve quality and reduce costs.

These high leverage topic areas include streamlining patient flow in health care settings; working with health plans and care coordination providers on approaches to post-acute care that results in enhanced care management; increasing value, patient affordability, and appropriate use of specialty drugs by applying evidenced based criteria to prescribing practices; addressing acute pain management in sickle cell patients; and utilizing big data analytics to reduce preventable harm in health care. Examples of funded projects for “Interventions that are Ready for Spread and Scalability” include:

  • Alliant Quality, utilizing the breakthrough collaborative model, will work with 30 emergency departments in Georgia and North Carolina to improve the triage, treatment, and quality of care received by patients with sickle cell disease who present to the emergency room in vaso-occlusive crisis (VOC). It is expected that interventions will result in appropriate and timely pain management and improved patient experience.
  • Atlantic Quality Innovation Network, working in New York (Orange, Putnam, and Dutchess Counties) with physician offices, pharmacies, hospitals, nursing homes and county health departments, seeks to modify and standardize prescribing practices for managing anticoagulants during the periprocedural period to reduce anticoagulant adverse drug events in all patients, including Medicare Fee-for-Service beneficiaries. Interventions include the operationalization of a mobile/web-based application for clinical decision support in hospital/ambulatory surgery settings and optimization of patient education using health information technology.
  • Qualis Health, working in Washington and Idaho, seeks to improve the quality, safety, and reliability of the care transition process by focusing on a comprehensive assessment of the social determinants impacting beneficiaries’ transitions from the hospital to the home and creating robust linkages to community social service providers for high-risk beneficiaries to improve care coordination and reduce avoidable medical care utilization.

CMS sought proposals with scientific rigor, a strong analytic framework and a reasonable, proposed intervention based on the supporting evidence. CMS looked for evidence of QIN-QIO partnerships at the community, regional and national levels, and inclusion of patients and families in each project as well as direct links to the CMS Quality Strategy goals.

A complete list of 2016 SIP awardees is located on the QIO Program website.

We are committed to innovation and are excited to study the results produced by these SIPs and to identify ways in which to incorporate them throughout the QIO Program based upon their results. The SIPs create an exciting opportunity for providers, professional organizations, innovation labs, and others to innovate and impact health care quality in the Medicare program at local, regional and national levels through the QIO Program.

Medicare’s investment in primary care shows progress

By Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

Today, the Centers for Medicare & Medicaid Services (CMS) announced the Comprehensive Primary Care (CPC) initiative’s second round of shared savings results, with nearly all practices (95 percent) meeting quality of care requirements and four out of seven regions sharing in savings with CMS. These results reflect the work of 481 practices that served over 376,000 Medicare beneficiaries and more than 2.7 million patients overall in 2015.

As the largest test of advanced primary care in U.S. history, CPC demonstrates the potential of primary care clinicians redesigning their practices to deliver better care to their patients, and provides clinicians support to innovate and deliver care in ways that better meet their patients’ needs and preferences.

During 2015, its second shared savings performance year, CPC generated a total of $57.7 million gross savings in Part A and Part B expenditures. These savings are essentially equivalent to the $58 million paid in care management fees to the practices. Four of the seven regions participating in CPC – the states of Arkansas, Colorado, and Oregon, and the Greater Tulsa region in Oklahoma – realized net savings (after accounting for the care management fees paid) and will share in those savings with CMS. Although three of the CPC regions had net losses, the savings generated in the other four regions covered those losses, such that care management fees across CPC were offset by reduced spending on Medicare Part A and Part B services. Further, more than half of participating CPC practices will receive a share of over $13 million in earned shared savings.

In addition to the gross Medicare savings, CPC practices showed positive quality, with lower than expected hospital admission and readmission rates, and favorable performance on patient experience measures. CPC practices’ performance on electronic Clinical Quality Measures (eCQMs) also exceeded national benchmarks, particularly on preventive health measures.

This is the first year CMS has included eCQM performance in Medicare shared savings determinations for CPC. eCQM reporting covering the entire practice population at the practice site level is critical to using health information technology as a tool to support care delivery transformation. eCQM data are recorded in the electronic health record in the routine course of clinical care, allowing practices to engage in real time quality improvement efforts that drive population health. As we move to a health care system that rewards value over volume, CPC practices are at the forefront of using eCQMs for quality improvement, measurement, and reporting.

Quality highlights from the 2015 shared savings performance year include:

  • 97 percent of CPC practices successfully reported 9 eCQMs. For ten out of the eleven eCQMs in the CPC measure set, the majority of CPC practices who reported surpassed the median national performance.
  • Nearly all (99 percent) practices reported higher levels of colorectal cancer screening and influenza immunization compared to national benchmarks. Additionally, 100 percent of practices who reported on screening for clinical depression surpassed national benchmarks.
  • Compared to 2014, most regions maintained or improved their scores on hospital readmissions and admissions for chronic obstructive pulmonary disorder and congestive heart failure.
  • Patients rated the care they receive from their CPC practitioners highly, particularly on how well practitioners supported them in taking care of their own health and the attention they paid to care from other providers.

The positive performance is a testament to the efforts CPC practices have made to provide truly “comprehensive primary care.”

CPC is a multi-payer partnership launched by the Center for Medicare and Medicaid Innovation (Innovation Center) in October 2012 to advance primary care by paying clinicians to deliver accessible, comprehensive, and coordinated care in seven regions across the country. CPC supports advanced primary care as the foundation of our health system. In addition to attending to patients’ acute, chronic, and preventive health care needs, primary care practices act as the quarterback of each patient’s health care team. CPC practices help patients navigate their care, communicate with specialists and hospitals, and ensure that patients with complex social and medical needs do not “fall through the cracks” of the health care system.

These results build on the first shared savings performance year in 2014. Gross savings nearly doubled from the first performance year to the second and practices in four regions were eligible to receive shared savings, compared to one region in 2014. Primary care transformation takes time, and it is especially encouraging that CPC practices maintained such positive quality of care results while also seeing gross Medicare savings in the 2015 performance year.

The experience in CPC has contributed to our continued efforts to support primary care going forward in the Innovation Center’s Comprehensive Primary Care Plus (CPC+), which will begin on January 1, 2017 and for which we recently announced the 14 selected regions and are currently reviewing practice applications. CMS anticipates that CPC+ could meet the criteria to qualify as an Advanced Alternative Payment Model (Advanced APM) under the recently finalized Quality Payment Program rule, which implements the Medicare Access and CHIP Reauthorization Act of 2015. A robust primary care system is essential to achieve better care, smarter spending, and healthier people. For this reason, CMS is committed to supporting primary care clinicians to deliver the best, most comprehensive primary care possible for their patients.

Tackling Tough Issues Together: The CMS Rural Health Council Solution Summit

By Cara James, Director of CMS Office of Minority Health and John Hammarlund, Regional Administrator 

In 1909, President Theodore Roosevelt’s Country Life Commission issued a report finding that in rural populations, “the physicians are further apart and are called in later in cases of sickness, and in some districts, medical attendance is relatively more expensive.” We have made progress in closing some of the access gap in recent years. Since the Affordable Care Act was signed into law by President Obama in 2010, uninsured rates in rural America have dropped by nearly 40 percent with corresponding improvements in access to care. Nevertheless, rural Americans are more likely to live in states that have not expanded Medicaid, more likely to live in areas with fewer physicians per capita, and more likely to have difficulty accessing timely emergency care.

To address these issues, earlier this year CMS established the CMS Rural Health Council. Made up of experts from across the agency, the Rural Health Council has been thinking about three strategic areas – first, ways to improve access to care for all Americans in rural settings; second, ways to support the unique economics of providing health care in rural America; and third, making sure the health care innovation agenda appropriately fits rural health care markets.

Supported by the Council, CMS has undertaken a number of efforts to reach out to stakeholders to hear about ways to improve access to services for rural Americans. CMS has rural health coordinators at each of our Regional Offices, who meet monthly with the Health Resources and Services Administration (HRSA) to discuss emerging issues. During the Rural Health Open Door Forums, CMS engages with stakeholders to provide current information on CMS programs, answer questions, and learn about emerging rural health issues.

Through our rural health coordinators and the Rural Health Council, CMS has conducted nearly two dozen listening engagements nationwide on key rural health issues, such as telemedicine, hospice, and hospital support. We’ve heard directly from physicians and hospitals who are treating their patients while juggling the unique challenges of rural health care.

In recent years, CMS reformed Medicare regulations that were identified as obsolete or excessively burdensome on hospitals and rural health care providers, which will save providers nearly $660 million annually and $3.2 billion over five years.

Going forward, we’re continuing to embed a rural focus into new programs. For example, with the proposed new Quality Payment Program, we’re making a special effort to reach clinicians in rural areas. Through technical assistance and other activities, we’ll help them transition to the proposed Quality Payment Program’s new approach for paying clinicians for the value and quality of care they provide.

We hope that all of our ongoing efforts, including the work of the CMS Rural Health Council, will give us a better understanding of how our policies and programs affect rural communities.

But we can’t address the challenges of rural communities alone. That’s why we recently announced we will be conducting the CMS Rural Health Solutions Summit on October 19, 2016, at CMS headquarters in Baltimore, Maryland. The CMS Rural Health Council will be bringing in stakeholders from all sectors of the health care industry as we engage in in-depth discussions about ways to improve access to care in rural America and support local innovation in care delivery. We’re excited to bring together national, state, and local leaders to discuss innovative strategies for improving rural care, access, and cost. This discussion will help us work together towards rural health policy and implementation that drives high-value, high-quality health care. If you’d like to join our conversation on October 19, please register at https://register.mitre.org/CMS_Rural_Health_Solutions_Summit/index.html

 

The Medicare Current Beneficiary Survey: Celebrating Our 25th Anniversary and a Bright Future Ahead

By Niall Brennan, Chief Data Officer, CMS

This year marks the 25th anniversary and the one millionth beneficiary interview for the Medicare Current Beneficiary Survey (MCBS), a survey that the Centers for Medicare & Medicaid Services (CMS) first fielded in 1991. This in-person survey of 15,000 Medicare beneficiaries collects valuable information about aspects of the Medicare program that cannot be analyzed based on CMS administrative data alone.  In particular, the MCBS gathers information on self-reported health status, satisfaction with care, and functional limitations.  The MCBS also collects information on beneficiaries that is key to understanding patient-centered care.   Beneficiary’s out-of-pocket spending and source of payment for medical services received outside the Medicare program provides a window into the “invisible” and missed costs of health care. One unique aspect of the MCBS is that it includes beneficiaries who reside in institutional settings, such as a nursing home, as well as those in the community.

The MCBS is used across CMS to provide important insights that support internal program analyses.  For example, over the past several years, the MCBS has become a key resource for evaluating the impact of CMS Innovation Center demonstration models as well as for approving Medicare Advantage and Prescription Drug Plan benefits.

The MCBS also serves as the foundation for thousands of health policy analyses across a diverse external user community.  To date, we know of more than 1,000 peer-reviewed papers based on MCBS data in leading publications such as the New England Journal of Medicine, the Journal of the American Medical Association, Journal of Health Economics, and the Journal of the American Geriatrics Society.

Today, I want to acknowledge a number of important efforts CMS has undertaken to ensure the MCBS remains a valuable resource for the agency and external stakeholders.  We have made the data more accessible, releasing the first ever MCBS public use file in May of this year.  While MCBS data files have always been available for a relatively nominal fee, we heard that this fee was a barrier to entry for certain users such as students.  We believe that increased access through this freely available public resource will expand the MCBS user community, and thus help cement its importance as a critical tool in the evaluation of systemic changes in the US health care delivery system.

We are also implementing changes to the MCBS questionnaire and survey design.  Revising and improving the survey questions is underway.  We have added new relevant content including an updated dental utilization module, a module on care coordination, and new questions on food security.   Enhancing the sampling methodology to include newly enrolled beneficiaries in the first year of their Medicare enrollment, conducting an oversample of Hispanic beneficiaries, and, beginning in 2017, conducting an oversample of low-income beneficiaries increase our ability to conduct disparities research and improve our survey estimates.

We are also committed to a more rapid data release schedule, with improved user documentation and file structure.  The 2015 MCBS files will be the first to have many of the improvements discussed above. We anticipate releasing the 2015 data file in the 2nd quarter of 2017, more than one year earlier than the previous file release schedule.   The release of the 2015 data will also include improved chart books to accompany data releases and more intuitive naming conventions and file layouts with modern file formats for SAS, Stata, and R use.  However, to accommodate these long overdue innovations, we had to make the difficult decision not to release 2014 data files.

As we celebrate our 25th anniversary of the MCBS, we are renewing our commitment to providing the most useful and relevant information about the Medicare program and, more importantly, the health and satisfaction of its beneficiaries.

We hope that you’ll visit us on our MCBS webpage at https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/MCBS/index.html where you can also subscribe for important updates and announcements.

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Delivering coordinated, high quality care for patients

By Dr. Patrick Conway, Acting Principal Deputy Administrator and Chief Medical Officer

In July 2016, CMS proposed new bundled payment models that continue the Administration’s progress to shift Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals and clinicians to deliver better care to patients at a lower cost. These proposed new bundled payment models focus on heart attacks, heart bypass surgery, and hip fracture surgery. They would reward hospitals that work together with physicians and other providers to avoid complications, prevent hospital readmissions, and speed recovery. This proposal follows the implementation of the Comprehensive Care for Joint Replacement Model that begin earlier this year, which introduced bundled payments for certain hip and knee replacements.

Patients want the peace of mind that comes with knowing they will receive high quality, coordinated care from the minute they are admitted to the hospital through their recovery. Bundling payments for services that patients receive across a single episode of care – such as a heart bypass surgery or hip replacement – encourages better care coordination among hospitals, doctors, and other health care providers. Providers participating in bundled payments must work together when patients are in the hospital as well as after they are discharged, which should improve their recovery and avoid preventable complications and costs by keeping people healthy and at home.

Doctors, patient advocates, and health care experts across the country support these models because they have seen firsthand their potential for delivering better quality and more cost-effective care. Public and private-sector bundled payment models have already shown promise in improving patient outcomes while lowering costs, including for cardiac and orthopedic care. In Medicare, more than 1,400 providers are currently participating in bundles through the Bundled Payments for Care Improvement initiative. Early results are encouraging: orthopedic surgery bundles, in particular, have shown promising results on cost and quality in the first two years of the initiative. These models keep the patient at the center of care delivery and focus on well-coordinated, high quality care.

Today, CMS is releasing the second annual evaluation report for Models 2-4 of the Bundled Payments for Care Improvement initiative, which include both retrospective and prospective bundled payments that may or may not include the acute inpatient hospital stay for a given episode of care. This report describes the characteristics of the participants and includes quantitative results from the first year of the initiative. Future evaluation reports will have greater ability to detect changes in payment and quality due to larger sample sizes and the recent growth in participation of the initiative, which generally is not reflected in this report. Key highlights include:

  • 11 out of the 15 clinical episode groups analyzed showed potential savings to Medicare. Future evaluation reports will have more data to analyze individual clinical episodes within these and additional groups;
  • Orthopedic surgery under Model 2 hospitals showed statistically significant savings of $864 per episode while showing improved quality as indicated by beneficiary surveys. Beneficiaries who received their care at participating hospitals indicated that they had greater improvement after 90 days post-discharge in two mobility measures than beneficiaries treated at comparison hospitals; and
  • Cardiovascular surgery episodes under Model 2 hospitals did not show any savings yet but quality of care was preserved. Over the next year, we will have significantly more data available, enabling us to better estimate effects on costs and quality.

While there is more work to be done, CMS continues to move forward to achieving the Administration’s goal to have 50 percent of traditional Medicare payments tied to alternative payment models by 2018. The 2016 goal of tying 30 percent of Medicare payments to alternative payment models was met eleven months ahead of schedule, and we are committed to keeping that momentum. Bundled payments – including the ongoing Comprehensive Care for Joint Replacement Model – continue to be an integral part of transforming our health care system by creating innovative care delivery models that support hospitals, doctors, and other providers in their efforts to deliver better care for patients while spending taxpayer dollars more wisely.

To view the evaluation report, please visit the CMS Innovation Center website at: https://innovation.cms.gov/Data-and-Reports/index.html.

Accountable Health Communities Track 1 Funding Opportunity

By Patrick Conway, M.D., principal deputy administrator and chief medical officer, CMS

In January 2016, the Centers for Medicare & Medicaid Services (CMS) released a new Funding Opportunity Announcement (FOA) for a model called the Accountable Health Communities (AHC) Model. This is the first Center for Medicare & Medicaid Innovation model to focus on the health-related social needs of Medicare and Medicaid beneficiaries. Many of these social issues, such as housing instability, hunger, and interpersonal violence, affect individuals’ health, yet they are rarely, if ever, detected or addressed during typical health care-related visits. The AHC Model is based on emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs.

The original Funding Opportunity Announcement requested applications for three different scalable tracks featuring interventions of varying intensity that would address health-related social needs for beneficiaries. After receiving significant interest, inquiries and stakeholder feedback, CMS has decided to make modifications to the Track 1 application requirements and is releasing a new FOA specific to Track 1 of the AHC Model. CMS believes two key modifications to Track 1 will make the model more accessible to a broader set of applicants

  1. Reducing the annual number of beneficiaries applicants are required to screen from 75,000 to 53,000; and
  1. Increasing the maximum funding amount per award recipient from $1 million to $1.17 million over 5 years.

Track 1 will support bridge organizations that are working to increase a patient’s awareness of available community services through screening, information dissemination, and referral. The Track 1 approach seeks to address the decreased capacity of clinical delivery sites to respond to beneficiaries’ health-related social needs because (1) health-related social needs remain undetected due to the lack of universal screening and (2) clinical delivery sites and patients may lack awareness about existing community service providers that could address those needs.  Track 1 award recipients will partner with the state Medicaid agency, community service providers and clinical delivery sites to implement the Model.

The AHC Model complements CMS’ growing focus on population health by providing the necessary tools and support for a successful transition to a holistic health system. The AHC Model will also enhance CMS’ understanding of the impact of interventions to address social needs on health care costs.

We look forward to the applications to this FOA. Please contact us at the email address below for further information.

Application Information:

Under this announcement, CMS is accepting applications from community-based organizations, health care practices, hospitals and health systems, institutions of higher education, local government entities, tribal organizations, and for-profit and non-for- profit local and national entities with the capacity to develop and maintain relationships with clinical delivery sites and community service providers.  Applicants from all 50 states, U.S. Territories, or the District of Columbia (D.C.) may apply. All applicants, including those who applied to Tracks 1, 2 or 3 in the previous FOA, are eligible to apply to this FOA. Applicants that previously applied to Track 1 of the AHC Model under the original FOA (# CMS-1P1-17-001) must re-apply using this FOA (# CMS-1P1-17-002) to be considered for the Model.

The AHC Model is accepting applications for Track 1 at www.grants.gov through November 3, 2016.

Have a Question?

Questions about the AHC Model can be sent to AccountableHealthCommunities@cms.hhs.gov.

Additional Information:

For more information about the AHC Model, please visit our website at https://innovation.cms.gov/initiatives/ahcm. Follow us on Twitter at @CMSinnovates

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