More on Medicare & Medicaid

CMS is now accepting grant applications from rural communities to improve healthcare

The amount of upfront and monthly payments will vary based on the level of risk that the ACO accepts in the Medicare Shared Savings Program.

The Centers for Medicare and Medicaid Services today released a notice of funding opportunity for rural communities across the country.

Under the Community Health Access and Rural Transformation Model Community Transformation Track, CMS will award grants to up to 15 rural communities to work with healthcare providers and payers. The goal of this initiative is to improve access to high-quality, sustainable and value-based care, according to CMS.

The award recipients will receive cooperative agreement funding and a program framework to assess the needs of their community and implement a healthcare delivery system redesign. Hospitals participating in the alternative payment model will receive capitation payments.

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To be eligible, organizations must represent a rural community as classified by the Federal Office of Rural Health Policy. Applications will be accepted until February 26, 2021.

In addition to the Community Transformation Track, CMS created the Accountable Care Organizations Transformation Tack. This program will select up to 20 rural-focused ACOs to receive advance payments as part of joining the Medicare Shared Savings Program. The amount for the upfront payment and monthly payments will vary based on the level of risk that the ACO accepts in the Medicare Shared Savings Program and the number of rural beneficiaries assigned to it, up to a maximum of 10,000 beneficiaries, according to CMS.

The request for application for the ACO Transformation Track will be available in early 2021.

The CHART Model expects to reduce Medicare spending by more than $80 million over the next seven years, while also improving the quality and coordination of care for up to one million beneficiaries, CMS said.


Approximately 57 million Americans live in rural communities and face a set of unique challenges to receiving healthcare that ultimately leads to worse health outcomes and higher rates of preventable diseases than those living in urban areas, according to CMS.

Hospitals in rural areas also face challenges not felt as severely as their more urban counterparts. The shift towards more outpatient care, competition from larger health providers and troubles with staffing have led to the closure of hundreds of rural hospitals over the past decade, according to a report in the Medicare and Medicaid Research Review.

Through the CHART Model, CMS aims to address disparities by providing rural communities with tools to transform their care delivery systems, including financial arrangement and operational and regulatory flexibilities.


Even before the coronavirus pandemic, many rural hospitals were in dire financial situations. A quarter of rural hospitals in the U.S. are at a high risk of closing unless they can improve their finances, according to a study conducted prior to the pandemic.

In recent months, the government has taken several actions to empower rural hospitals.

President Trump's Executive Order on Improving Rural Health and Telehealth Access especially targets telehealth for rural communities and hospitals, which may lack the funds needed for the infrastructure. Following that, CMS released the CHART Model.

CMS also has a Rethinking Rural Health initiative that works to develop programs and policies for rural providers and patients.

Twitter: @HackettMallory
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