New CMS Value-Based Model Aims to Improve Rural Healthcare

    To expand Telehealth adoption and increase access to affordable, high-quality care in rural and underserved communities, the Centers for Medicare and Medicaid Services (CMS) announced the Community Health Access and Rural Transformation (CHART) Model earlier this week. 

    Built from the recently signed executive order on Improving Rural Health and Telehealth Access, the CHART Model aims to transform the healthcare delivery systems in rural areas through new payment structures, updated financial arrangements, and operational and regulatory flexibilities. 

    New Possibilities for Rural Healthcare

    According to CMS, approximately 57 million Americans live in rural communities. Many of them are Medicare and Medicaid beneficiaries who struggle to access healthcare due to unique challenges, such as “limited transportation options, shortages of healthcare services, and an inability to fully benefit from technological and care-delivery innovations.” The agency hopes that building care systems where providers get paid based on quality and outcomes instead of volume will help address these disparities.

    Interested rural healthcare providers can participate in two tracks: the Community Transformation Track or the Accountable Care Organization (ACO) Transformation Track.

    Community Transformation Track

    CMS will select a maximum of 15 Lead Organizations, single entities representing a rural community such as state Medicaid agencies or local public health departments.

    The chosen Lead Organizations, which CMS will announce in early 2021, will receive upfront cooperative agreement funding of up to $5 million, predictable capitated payments (CPA), and operational and regulatory flexibilities.

    ACO Transformation Track

    As part of joining the Medicare Shared Savings Program, 20 CMS-selected rural ACOs will receive advance payments to help them “engage in value-based payment efforts that will improve outcomes and quality of care for rural beneficiaries.” All the details are available in a CMS CHART Model Fact Sheet

    The Request for Application (RFA) for this track is expected to release in spring 2021, while the selection of the 20 participants won’t be until January 2022.

    Expanding Telehealth Coverage

    One of the CHART Model’s key elements is the further expansion of Telehealth coverage beyond the coronavirus pandemic. Even before the pandemic hit, one of the biggest hindrances to the adoption of Telehealth and mHealth technologies among rural providers was the lack of financial support.

    However, with the CHART Model offering financial backing and encouragement to utilize and take full advantage of connected health platforms, it’s likely things will begin to change soon.