States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model


States Advancing AHEAD aims to address unsustainable health care cost growth, poor population health, and unacceptable disparities in health outcomes by increasing investment in primary care and health related social needs and constraining total cost growth. Overall goals: Improve population health Increase equity of health outcomes Stem rising healthcare costs Beneficiaries impact goals: Receive efficient, high quality, coordinated care from all providers Receive equitable treatment and access to community resources Improve affordability of high-value care

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Centers For Medicare and Medicaid Services, Department of Health and Human Services
Type(s) of Assistance Offered
B - Project Grants
Program Accomplishments
Not applicable.
Social Security Act, section 1115A
Section 1115A of the Social Security Act (the Act) establishes CMMI to test innovative health care payment and service delivery models that have the potential to lower Medicare, Medicaid, and CHIP spending while maintaining or improving the quality of beneficiaries’ care.
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Application to the NOFO will be open to all 50 US states, Washington, DC, and Puerto Rico
Beneficiary Eligibility
All Medicare FFS beneficiaries in the state or region that meet eligibility criteria (e.g., residents in the state for a minimum defined period of time) will be included in the all-payer and Medicare FFS TCOC growth and Primary Care Investment Targets, and statewide population health and quality measures and targets. Beneficiaries are eligible to be aligned to a hospital or primary care provider if during the alignment look back period the beneficiary lived in the participating state and were covered by both Part A and Part B of Medicare.
Not applicable.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. Interested applicants will submit their applications via
Award Procedure
All qualified applications will be forwarded to an objective review committee. The results of the objective review of the applications by qualified experts will be used to advise the CMS approving official. In making these decisions, the CMS approving official will take into consideration: recommendations of the review panel; the readiness of the applicant to conduct the work required; the scope of overall projected impact on the aims; reviews for programmatic and grants management compliance; the reasonableness of the estimated cost to the government and anticipated results; and the likelihood that the proposed project will result in the benefits expected. Notification is made in writing by a Notice of Award (NoA).
Application deadline will be 60 calendar days after the NOFO is published on
Approval/Disapproval Decision Time
Application review period will take approximately 90 days
Not applicable.
Not applicable.
How are proposals selected?
To be determined
How may assistance be used?
Cooperative Agreement funding will support the following activities: • Develop Health equity plan, and select state quality measures • Form state governance structure • Engage commercial payers, recruit hospitals • Establish All-Payer and Medicare TCOC growth targets and primary care investment targets • Identify eligible primary care providers for Primary Care AHEAD • Onboard to necessary CMS systems • Attend required learning events
What are the requirements after being awarded this opportunity?
Not applicable.
Not applicable.
Recipients are required to maintain grant accounting records 3 years after the date they submit the final Federal Financial Report. If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formula is not applicable to this assistance listing.

Matching requirements are not applicable to this assistance listing.

MOE requirements are not applicable to this assistance listing.
Length and Time Phasing of Assistance
The estimated period of performance is 5 years. Method of awarding/releasing assistance: Recipients drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web-based payment system for HHS awards. Method of awarding/releasing assistance: Quarterly.
Who do I contact about this opportunity?
Regional or Local Office
Headquarters Office
Katherine J. Sapra, PhD, MPH
7500 Security Blvd.
Baltimore, MD 21244 US
Phone: 410.746.0228

Emily H. Moore, MPH
7500 Security Blvd
Baltimore, MD 21244 USA
Phone: 443-981-0338
Financial Information
Account Identification
(Cooperative Agreements) FY 22$0.00; FY 23 est $0.00; FY 24 est $12,000,000.00; FY 21$5,000,000.00; FY 20$7,000,000.00; FY 19$7,000,000.00; FY 18$0.00; FY 17$10,000,000.00; FY 16$0.00; -
Range and Average of Financial Assistance
CMS will make a total of $12 million available to states or sub-state regions participating in States Advancing AHEAD. Awardees will be able to select either a 9-month, 1-year or 2-year Pre-Implementation timeline based on their perceived readiness to implement the Model. Depending on timeline selected, awardees will receive either $3 million (9-month or 1-year) or $5.25 (2-year) for the Pre-Implementation Period and $2.25 million annually for the first 3-4 Full Implementation Period performance years.
Regulations, Guidelines and Literature
Not applicable.
Examples of Funded Projects
Not applicable.


Federal Grants Resources