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Analysis

CMS Unveils Initiative to Transform Rural Health

By John Commins  
   August 12, 2020

The Community Health Access and Rural Transformation Model will pick 15 rural communities for its Community Transformation Track, which starts next summer.

The Trump Administration has unveiled a two-track pilot program that will provide $75 million in "up-front funding" for 15 rural communities to transform their care delivery models.

The volunteer Community Health Access and Rural Transformation (CHART) Model will pick 15 rural communities for its Community Transformation Track, which begins next summer.

The Centers for Medicare & Medicaid Services will also accept applications for 20 slots in a related Accountable Care Organization Transformation Track to begin in January 2022.

CMS Administrator Seema Verma said the agency was acting on an Aug. 3 executive order by President Donald J. Trump calling for a new model "to ensure that rural healthcare providers are able to provide the necessary level and quality of care."

"This new model is appropriately called CHART, or the Community Health Access and Rural Transformation Model, because it charts a course to a sustainable healthcare delivery system in rural communities," Verma said at a media teleconference Tuesday.

Verma said the model "provides three things for rural communities."

"First, it provides new upfront seed funding for rural communities to organize their efforts to transform healthcare delivery in their communities."

"Second, it allows for operational and regulatory flexibilities that enabled enhance care for fee for service beneficiaries."

"Third, it offers technical and learning support to participants to ensure the model success," she said.

CMS will detail the CHART models during a webinar on Aug. 18 at 1 p.m. ET.

Under the model, Verma said, 15 select rural community stakeholders and state Medicaid organizations could receive up to $5 million over 18 months to help transform care delivery. 

The model would also provide capitated payments that de-emphasize volumes for participating hospitals, and also could waive Conditions of Participation in specific circumstances when requested to do so by applicants.

CMS believes this would allow rural hospitals to move to outpatient- and emergency department-focused models instead of relying entirely on inpatient models. It would also allow rural providers to ramp up telehealth services or develop hub-and-spoke arrangements with larger, regional providers.

In turn, the model participants would be held accountable for quality outcomes measured by total cost, admissions and ER visits, and other metrics that the community would pick.

CMS said the related ACO Transformation Track builds on the success of the ACO Investment Model, which the agency claims has saved $382 million over three years.

The ACO Transformation Track participants will enter a two-sided risk arrangements as part of the Medicare Shared Savings Program and may use all waivers available in the MSSP program.

Verma said CMS will issue a Request for Applications in the Spring of 2021 and pick 20 rural ACOs to participate starting in January 2022. 

“This new model is appropriately called CHART, or the Community Health Access and Rural Transformation Model, because it charts a course to a sustainable healthcare delivery system in rural communities.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

Photo credit: Allison Shelley/Getty Images


KEY TAKEAWAYS

Under the model, 15 select rural community stakeholders and state Medicaid organizations could receive up to $5 million over 18 months to help transform care delivery. 

The model would also provide capitated payments that de-emphasize volumes for participating hospitals, and also could waive Conditions of Participation in specific circumstances when requested to do so by applicants.

CMS believes this would allow rural hospitals to move to outpatient- and emergency department-focused models instead of relying entirely on inpatient models.

It would also allow rural providers to ramp up telehealth services or develop hub-and-spoke arrangements with larger, regional providers.

Model participants would be held accountable for quality outcomes measured by total cost, admissions and ER visits, and other metrics that the community would pick.


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