AHEAD Model Review (W6011)-AHEAD Model Review Presentation

AHEAD Model Review Presentation

Pdf Summary

The January 28, 2026 presentation by the Georgia Hospital Association (GHA), featuring healthcare expert Patrick Dooley of Berkeley Research Group (BRG), focuses on the ongoing transformation in hospital finance and operations driven by the Centers for Medicare & Medicaid Services (CMS) shift toward value-based care and hospital global budgets under the AHEAD Model. Patrick Dooley brings extensive experience from state government and large health systems in Maryland, specializing in Medicaid expansion, alternative payment models, and population health management.<br /><br />BRG is a global consulting firm providing multidisciplinary expertise in healthcare performance improvement, corporate finance, and dispute resolution. Their healthcare consulting services cover analytics, clinical economics, compliance, policy, and strategic advisory.<br /><br />Hospitals face increasing financial pressures from declining margins, rising costs, and evolving CMS payment models that move away from fee-for-service (FFS) toward population-based, downside risk models. The AHEAD Model—now renamed Achieving Healthcare Efficiency through Accountable Design—enrolls states voluntarily in hospital global budget programs aiming to cap Medicare FFS revenue while encouraging cost control and quality improvements. Six states were initially approved, with more expected to apply in spring 2026; implementation for new entrants will begin in 2029.<br /><br />Global budgets shift hospital incentives and operations toward fixed, predictable revenue and population health management, requiring integrated care delivery, advanced data analytics, workforce innovation, and new governance frameworks. Strategic planning under global budgets emphasizes right-sizing service lines based on population needs, avoiding unnecessary utilization, and leveraging ambulatory, behavioral health, and access services to protect margins.<br /><br />Hospitals’ success depends on their maturity in value-based care, progressing from fragmented, retrospective models to fully integrated, data-driven systems with predictive analytics and patient-centered approaches. High-performing systems exhibit unified strategy, integrated care management, data infrastructure, workforce development, and community engagement.<br /><br />GHA is positioned to help members navigate the transition by initiating readiness assessments, coordinating payer and provider expectations, standardizing analytics, developing comprehensive state roadmaps, and assisting with financial modeling and governance design, especially benefiting rural and safety-net hospitals.

Keywords

Georgia Hospital Association

Patrick Dooley

Berkeley Research Group

CMS value-based care

AHEAD Model

hospital global budgets

Medicaid expansion

alternative payment models

population health management

healthcare finance transformation