Affordable Care Act Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents

The Centers for Medicare and Medicaid Services (CMS) under the Department of Health and Human Services awards grants under CFDA 93.621 to fund clinical interventions reducing avoidable hospitalizations among nursing facility residents, with the most recent grant award disbursed on March 10, 2020.

Program activity has substantially contracted. CMS awarded 14 grants between September 2012 and March 2020, with award volume declining from 7 grants in 2012 to 1 grant in 2020. No new grant opportunities have been posted since the last award six years ago. The program funded payment and care coordination reforms tested through partnerships between eligible organizations and long-term care facilities. Representative awards include the Nevada Admissions and Transitions Optimization Program (ATOP) Phase Two, a cooperative agreement awarded in March 2020 for $2.9 million; the Alabama Alliance for Nursing Home Quality and Care Coordination, a cooperative agreement awarded in March 2016 for $14.8 million; and the Initiative to Reduce Avoidable Hospitalizations Payment Reform, also awarded in March 2016 for $17.7 million and $19.8 million in two separate cooperative agreements.

CMS is the sole funding agency across all 14 awards. Combined federal dollars obligated total $199.4 million. The assistance-type mix splits between Project Grants (57 percent, 8 awards) and Cooperative Agreements (43 percent, 6 awards). Recent awards ranged from $2.9 million to $19.8 million. The program is not actively soliciting new applications. The combination of dormancy since 2020, absence of recently posted opportunities, and declining award cadence suggests this program is not pursuing new initiatives at this time.