Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model
Active
- Assistance listing
- 93.968
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Grant awards
- 9 $125,883,905 in federal obligations
Program facts
- Also known as
- States Advancing AHEAD
- Assistance types
-
- Cooperative Agreement
- Project Grant
- Treasury account
-
- 75-0522-0-1-551
Program details come from SAM.gov Assistance Listings. Updated . Grant award figures come from USAspending.gov.
About this program
The Centers for Medicare and Medicaid Services (CMS) funds state-led alternative payment and service delivery models under the Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model (CFDA 93.968), with the most recent grant award issued on June 1, 2026, and the last posted opportunity due August 12, 2024.
The AHEAD Model supports state infrastructure and implementation of multi-payer healthcare cost and quality initiatives, including hospital global budgets, primary care payment reform, benefit enhancements for post-acute care and behavioral health, and statewide accountability targets for all-payer and Medicare cost growth, primary care investment, and health equity outcomes. Recent awards demonstrate focus on state governance structures, care transformation through new payment mechanisms, provider recruitment, and population health planning. Connecticut's most recent award ($14.4 million over 5 years) covers program staff, strategic planning, and contractor support for hospital global budgets and primary care payment reform. Rhode Island received $10 million to develop Medicaid and commercial alternative payment models and establish multi-payer total cost of care targets. New York was awarded $15.8 million to implement hospital global budgets, recruit primary care practices, and advance health equity initiatives.
CMS has awarded nine cooperative agreements and one project grant totaling $125.9 million in federal dollars obligated (combined federal and non-federal share: $127.4 million) since 2017. Awards cluster in recent years: four in 2024 and two in 2025. The portfolio is predominantly Cooperative Agreements (89 percent of awards). All nine awards have been issued by CMS.
Eligible applicants are state Medicaid agencies, state public health agencies, and other state agencies on behalf of all 50 states, Washington DC, and Puerto Rico. CMS will select up to eight award recipients per solicitation cycle, with a maximum of $12 million per applicant available over up to six years. The estimated period of performance is five years. The AHEAD Model operates for eleven years through December 31, 2034. The most recent posted opportunity (CMS-4S4-24-001, due August 12, 2024) has closed; no current solicitations are open. Application review takes approximately 90 days, with 60 calendar days from NOFO publication to application deadline in future cycles.
Objective and description
- Objective
The Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model (referred to as "AHEAD" or the "AHEAD Model"), is a voluntary, state-based alternative payment and service delivery model. It focuses on preventative care, empowering patien
- Description
The AHEAD Model is designed to address unsustainable growth of healthcare costs and suboptimal population health outcomes. The model relies on a state-led, multi-payer strategy to increase investments in primary care and prevention, and to improve care coordination across the delivery system.
Eligibility
- 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.
- Uses of assistance
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
- 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.
How to apply
- Criteria for selecting proposals
To be determined
- 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).
- Deadlines
Application deadline will be 60 calendar days after the NOFO is published on grants.gov
- Time to approval or disapproval
Application review period will take approximately 90 days
Grant opportunities
| Opportunity | Status | Posted | Applications due |
|---|---|---|---|
| States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model | Closed |
Grant awards
Top recipients by federal obligations
| Rank | Recipient | Federal obligations | Share |
|---|---|---|---|
| 1 | Pennsylvania Department Of Health | $23,998,228 | 19% |
| 2 | Office Of Health Strategy | $17,660,104 | 14% |
| 3 | Human Services Vermont Agency Of | $16,000,000 | 13% |
| 4 | Maryland Department Of Health | $15,807,410 | 13% |
| 5 | NYS Department Of Health | $15,797,800 | 13% |
| 6 | Department Of Social Services Connecticut | $14,406,424 | 11% |
| 7 | Department Of Human Services Hawaii | $12,213,939 | 10% |
| 8 | Health & Human Services, Rhode Island Executive Office Of | $10,000,000 | 8% |
Federal obligations by fiscal year
| Fiscal year | Federal obligations |
|---|---|
| FY2026 | $43,755,227 |
| FY2025 | $13,876,664 |
| FY2024 | $37,471,361 |
| FY2022 | $4,500,000 |
| FY2021 | $5,000,000 |
| FY2020 | $4,498,228 |
| FY2017 | $10,000,000 |
Quick answers
What is Assistance Listing 93.968?
Assistance Listing 93.968 is Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model, a federal grant program run by Centers for Medicare and Medicaid Services (Department of Health and Human Services).
What is the CFDA number for Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model?
Its CFDA number is 93.968: Assistance Listing numbers were called CFDA numbers before 2018.
How much funding has Assistance Listing 93.968 awarded?
9 grant awards under 93.968 have obligated $125,883,905 in federal funds to 8 recipients.
Who receives the most funding from 93.968?
The recipients obligated the most under Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model are Pennsylvania Department Of Health ($23,998,228), Office Of Health Strategy ($17,660,104) and Human Services Vermont Agency Of ($16,000,000).
How much did 93.968 obligate in fiscal year 2025?
Grants under 93.968 obligated $13,876,664 in federal funds in fiscal year 2025.
Are there open grant opportunities under 93.968?
No opportunity listed under 93.968 is open now. The latest, States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, was posted on July 31, 2023.
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