Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model

The CMS Innovation Center is announcing a new NOFO focused on improving the quality of care for high and rising risk children and youth in Medicaid and CHIP who either have or are at risk of developing complex medical and/or behavioral needs through

The ASPIRE Model will test an aligned care delivery and value-based payment (VBP) approach designed to improve outcomes for youth with complex medical, behavioral, or developmental needs. The model will increase access to coordinated, high-quality care by supporting State Medicaid Agencies and their collaborating accountable entities-such as pediatric accountable care organizations or managed care entities-to deliver enhanced care coordination and transitional care. The model will operate in up to five states and will focus on improving quality, reducing avoidable utilization, strengthening family experience, and supporting enhanced care coordination.

State Medicaid agency

Medicaid and CHIP (with inclusion of CHIP beneficiaries optional for states) children and youth under age 21 identified as at high and rising risk (HRR) for poor health outcomes.

Cooperative Agreement funding is to be used for Recipient's costs in developing and operationalizing the ASPIRE Model. Cooperative agreement funding may be used for statewide infrastructure, staffing, health IT, interoperability projects, data analytics, payment model development, stakeholder engagement, and other activities necessary to operationalize the ASPIRE Model. Recipients will be required to develop the ASPIRE value-based payment (VBP) model in accordance with CMS and state-based Medicaid policy. Cooperative agreement cannot be used to finance the care delivery services provided under the Model. Recipients will be required to partner with CMS to develop the VBP model in accordance with CMS and state-based Medicaid policy. Cooperative agreement funds cannot be used to finance the care delivery services provided under the model.

Funding may not be used to: • Pay for direct medical services covered by Medicaid or CHIP • Duplicate or supplant existing federal or state funding • Cover construction or capital expenditures • Claim Federal Financial Participation (FFP)

To be determined and described in the NOFO.

All qualified applications will be forwarded to a merit review committee. The results of the merit 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).

The application deadline is from 4/30/27 - 8/31/27. Applications will be due by 8/31/2027. An optional Letter of Intent may be submitted by 6/18/2027. CMS will award cooperative agreement funding for a total of nine years and eight-month to a maximum of five award Recipients ("Recipients"). The Model consists of a twenty-month Pre-Implementation Period along with an eight-year Implementation Period as follows: • Pre-Implementation Period: January 2028 - December 2029 • Implementation Period: January 2030 - December 2037 Method of awarding/releasing assistance: Recipients draw down funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web-based payment system for HHS awards.