Program Basics
What does AHEAD stand for?
AHEAD stands for Advancing All-Payer Health Equity Approaches and Development.
Can a practice participate in both PC-AHEAD and MDPCP?
No — practices cannot participate in both programs at the same time.
What was the launch date for Cohort 1 of the Medicaid Path?
August 1, 2025.
When does the AHEAD Model officially begin?
January 1, 2026.
What tool provides real-time hospital and ED notifications?
CEND (CRISP Event Notification Delivery).
What are the three major components of Maryland’s AHEAD Primary Care Programs?
The three components are Medicaid Path, Medicare Paths (MDPCP/PC-AHEAD), and Infrastructure (EQUIP)
What Track will continue in MDPCP after Track 3 ends in 2025?
Only Track 2 will remain in MDPCP starting in 2026.
What is the PMPM Care Management Fee for Medicaid Path practices?
$2 per member per month (PMPM) for assigned HealthChoice members.
What is the last date that MDPCP Track 3 will be active?
December 31, 2025
What platform helps practices track population health metrics?
Multi-Payer Reporting Suite.
What are the goals of the AHEAD Model?
To enhance quality care, achieve all-payer alignment, and improve health outcomes while reducing administrative burden.
What is the expected payment difference between PC-AHEAD and MDPCP?
PC-AHEAD is expected to have lower payment levels compared to MDPCP.
What is the minimum number of HealthChoice members required to join in 2025?
250 assigned HealthChoice members as of March 15, 2025.
By when must MDPCP practices join the Medicaid APM to continue participating?
By January 1, 2027.
What is required every 90 days for CEND panels?
Submit or update CEND panels that include assigned Medicaid patients.
Which agency will run the PC-AHEAD program nationally?
CMMI (Center for Medicare & Medicaid Innovation). Acceptable CMS?
What is one major reason PC-AHEAD was created?
To attract new participants into the Medicare APM who are not in MDPCP.
Are quality incentives required in 2025 for Medicaid Path?
No — quality incentives will not apply in 2025.
What is the final quarter in which PBA will be applied?
Q1 2026.
What is one example of a CRISP tool used in the Medicaid Path?
Any of: CRISP Portal, CEND panels, Multi-Payer Reporting Suite.
What are the two types of care models that must be aligned under the AHEAD Model?
Hospital Global Budgets and Advanced Primary Care.
Which practices is PC-AHEAD targeting for participation?
Practices not currently in MDPCP and interested in Medicare APM participation.
Name one of the care transformation requirements under the Medicaid Path.
Any of the following: Access to CRS/Multi Payer Reporting Suite, MCO assignment list mgmt, outreach to unengaged members, or CEND panel submission every 90 days.
What happens after a practice passes state and CMS vetting for PC-AHEAD?
They will be offered participation agreements for PC-AHEAD in Fall 2025 to begin in January 2026.
What are practices encouraged to do with existing workflows under the Medicaid Path?
Expand existing workflows to include Medicaid populations.