Recognizing that the way healthcare is funded and delivered in rural communities needs an overhaul, the Centers for Medicare & Medicaid Services (CMS) has unveiled a new approach it hopes will provide a roadmap for how to do just that.

The Community Health Access and Rural Transformation (CHART) model provides some new avenues and funding that rural providers can pursue to redesign and improve systems of care.

First, for rural communities, CMS has created a Community Transformation Track in which up to 15 rural communities will receive funding to pursue “delivery reform, provide predictable capitated payments, and offer operational and regulatory flexibilities” to build sustainable systems of care. For example, communities may take steps to expand the use of telemedicine, enable some outpatient clinics or EDs to be paid as if they are hospitals, and enable participating hospitals to waive cost-sharing for some part B-services.

CMS says it will begin the selection process for community participants in early fall; winners will be announced early next year. Implementation of the CHART model at the selected sites is set to begin in the summer of 2021.

Second, for rural providers, CMS has unveiled a new Accountable Care Organization (ACO) Transformation Track. This approach will deliver upfront investments to improve outcomes and quality for patients. Under this ACO track, providers will participate in two-sided risk arrangements as part of the Medicare Shared Savings Program.

Up to 20 rural ACOs will be selected to participate in this track, with implementation set to begin in January 2022. CMS anticipates applications to participate should be available to interested providers in spring 2021.

CMS says both tracks are designed to provide financial stability and remove regulatory burdens to healthcare providers, and to enhance both access and quality for patients who live in rural communities.

More information about the CHART model is available here.