Georgia’s rural hospitals are preparing for a multi-payer value-based payment model, with over 85 hospitals signing letters of intent to participate. The state’s $218.8 million federally approved program, known as the Georgia Rural Enhancement And Transformation of Health (GREAT), aims to transition the state’s rural healthcare ecosystem to a value-based model of care.
This model is based on the CMS Innovation Center’s Achieving Healthcare Efficiency through Accountable Design (AHEAD) model, which is already being used in six other states, including Maryland, Vermont, and New York. The AHEAD model seeks to transform how care is paid for, delivered, and measured, especially at the state, hospital, and primary care levels.
The first initiative in the GREAT Health program is making $56.7 million available to help prepare rural healthcare facilities and Georgia to succeed in this multi-payer value-based model of care. They are dedicating resources to work with healthcare facilities and leaders to assess readiness, identify gaps, provide technical assistance, and mitigate fiscal risk.
Related: Healthcare urged to tighten AI supply chain checks
The Georgia Department of Community Health is leading the AHEAD effort, which involves coordination between state government, hospitals, payers, and community stakeholders. To prepare for participation in the AHEAD Hospital Global Budget Model, hospitals and state agencies will need to undertake a series of strategic, operational, and technical steps.
Money spent assessing rural hospitals for capacity and financial viability and determining prerequisites for primary care participation will mean that AHEAD model funding from CMS can be spent more efficiently once the model is implemented. The GREAT Health Program will seek to make it possible for more rural hospitals, providers, and payers to participate in the AHEAD model, mitigate their start-up costs, and increase the provision of primary care and prevention services in rural counties.
The program will include strategies to conduct a statewide financial and technological assessment of all eligible model participant sites, provide grants to bring on technical support and project management, and receive funds to initiate projects to ensure long-term success of AHEAD model participation. It will also provide risk mitigation funds for RHT Program Years 4 and 5 to allow for real-time experiential learning to encourage long-term success of global budgeting.
Related: Understanding the Role of a Food Handlers Certificate in Preventing Contamination
The outcomes of this initiative will be measured by rural hospital participation in AHEAD, primary care providers participating in AHEAD, private payers participating in AHEAD, and an increase in the number of patients participating in annual wellness visits at the county-level. Targets for these metrics are 10% of rural hospitals, 100 primary care providers, 2 private payers, and a 10% increase in annual wellness visits.
The Georgia Department of Community Health will track these metrics and use the data to evaluate the effectiveness of the GREAT Health Program and make adjustments as needed. By focusing on value-based care and community engagement, the program aims to improve healthcare outcomes and reduce costs in rural Georgia.
