Opportunity Information: Apply for CMS 1E1 12 002
Apply for CMS 1E1 12 002
- The Centers for Medicare Medicaid Services in the health sector is offering a public funding opportunity titled "Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.621 Affordable Care Act Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.
- This funding opportunity was created on Apr 30, 2012 and posted on Mar 15, 2012.
- Applicants must submit their applications by Jun 14, 2012 No Explanation. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $128,000,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $30,000,000.00 in funding.
- The number of recipients for this funding is limited to 7 candidate(s).
- Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).
- CMS will consider applications from organizations (referred to as enhanced care coordination providers) that demonstrate the capacity to adequately implement the types of initiatives described above. Enhanced care coordination providers may include, but are not limited to Organizations that provide care coordination, case management, or related services Medical care providers, such as physician practices Health plans (although this Initiative will not be capitated managed care, and will not apply to beneficiaries enrolled in Medicare Advantage) Public or not for profit organizations, such as Aging and Disability Resource Centers, Area Agencies on Aging, Behavioral Health Organizations, Centers for Independent Living, universities, or others Integrated delivery networks, if they extend their networks to include unaffiliated nursing facilities. Nursing facilities, entities controlled by nursing facilities, or entities for which the primary line of business is the delivery of nursing facility/skilled nursing facility services are excluded from serving as enhanced care coordination providers under this cooperative agreement. Legal Status To be eligible, an organization must be recognized as a single legal entity by the State where it is incorporated, and must have a unique Tax Identification Number (TIN) designated to receive payment. The organization must have a governing body capable of entering into a cooperative agreement with CMS on behalf of its members.
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Opportunity Summary:
The Centers for Medicare and Medicaid Services (CMS) released this discretionary funding opportunity, titled the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (Funding Opportunity Number CMS-1E1-12-002; CFDA 93.621), to support real-world testing of evidence-based clinical interventions in Medicare- and Medicaid-certified nursing facilities. Through a cooperative agreement structure, CMS planned to select a limited number of organizations to implement enhanced care coordination and clinical strategies designed to improve outcomes for nursing facility residents and reduce unnecessary use of the hospital. The overall purpose is to strengthen day-to-day clinical care inside nursing facilities, improve how residents are managed when their conditions change, and ensure smoother transitions between hospitals and nursing facilities so that preventable admissions and readmissions decline over time.
The initiative is centered on four main objectives. First, awardees are expected to reduce the frequency of avoidable inpatient hospital admissions and readmissions originating from nursing facilities. Second, they must improve resident health outcomes, meaning better clinical stability and management of common conditions that often drive transfers to the hospital. Third, the work must improve the process of transitioning residents between inpatient hospitals and nursing facilities, which typically includes better communication, information sharing, medication reconciliation, discharge planning, and follow-up care. Fourth, CMS expects the interventions to reduce overall health care spending, but explicitly without restricting residents access to care or limiting their choice of providers. In other words, cost reductions are intended to come from better care and fewer preventable crises, not from barriers to medically necessary services.
A key design feature is the population focus. The interventions are primarily aimed at long-stay residents who are enrolled in both Medicare and Medicaid and who live in Medicare/Medicaid-certified nursing facilities. CMS emphasizes long-stay residents because they are more likely to experience recurring clinical complications and are at higher risk for avoidable transfers, compared with short-stay post-acute residents who are in a facility briefly after a hospitalization and then return home. By targeting long-stay dual-eligible residents, the initiative aims to address a population that often has complex medical needs, multiple chronic conditions, functional limitations, and high utilization patterns that can potentially be improved through stronger on-site care and coordination.
Funding for the program was substantial. CMS estimated a total of $128,000,000 available for this initiative, with an expected 7 awards. Individual awards were projected to range from a floor of $5,000,000 to a ceiling of $30,000,000, and there was no cost-sharing or matching requirement. The opportunity was posted March 15, 2012, created April 30, 2012, with an original and current closing date of June 14, 2012, and an archive date of July 14, 2012.
Eligibility is framed around the concept of an enhanced care coordination provider, meaning an organization capable of implementing the kinds of clinical and coordination interventions CMS is seeking. CMS indicated it would consider applications from a broad range of organizations that can demonstrate operational capacity, clinical capability, and coordination experience. Examples include organizations providing care coordination, case management, or related services; medical care providers such as physician practices; health plans (with the important caveat that this is not a capitated managed care initiative and does not apply to Medicare Advantage enrollees); and public or nonprofit organizations such as Aging and Disability Resource Centers, Area Agencies on Aging, behavioral health organizations, Centers for Independent Living, universities, and similar entities. Integrated delivery networks may also apply, particularly if they can extend their networks to include nursing facilities that are not already affiliated with them.
At the same time, CMS draws a clear boundary around who may not serve as the enhanced care coordination provider under this cooperative agreement. Nursing facilities themselves are excluded, as are entities controlled by nursing facilities, and entities whose primary line of business is delivering nursing facility or skilled nursing facility services. This exclusion signals CMS intent to have the coordinating entity be independent from the nursing facility industry’s core service line, likely to reduce conflicts of interest and to encourage broader system-level coordination across settings (nursing facility, hospital, clinicians, and community-based supports).
The announcement also includes basic legal and administrative eligibility requirements. Applicants must be recognized as a single legal entity in the state where incorporated, have a unique Tax Identification Number designated to receive payment, and have a governing body able to enter into a cooperative agreement with CMS on behalf of the organization and any participating members or partners. For access issues with the full announcement, the listing directs applicants to the Grants.gov Contact Center for support by phone or email during standard weekday hours.
Frequently Asked Questions (FAQs)
What is the title of this CMS funding opportunity?
The opportunity is titled Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.
What is the Funding Opportunity Number and CFDA number?
The Funding Opportunity Number is CMS-1E1-12-002, and the CFDA number is 93.621.
What type of funding mechanism is being used?
This opportunity uses a cooperative agreement structure, meaning CMS planned to work with a limited number of selected organizations to implement and test interventions in real-world nursing facility settings.
What is the main purpose of this initiative?
The overall purpose is to support real-world testing of evidence-based clinical interventions in Medicare- and Medicaid-certified nursing facilities to:
- Strengthen day-to-day clinical care inside nursing facilities
- Improve how residents are managed when their conditions change
- Improve transitions between hospitals and nursing facilities
- Reduce preventable hospital admissions and readmissions over time
What are the four main objectives CMS expects awardees to address?
CMS centered the initiative on four objectives:
- Reduce avoidable inpatient hospital admissions and readmissions originating from nursing facilities
- Improve resident health outcomes (for example, better clinical stability and management of common conditions that often drive hospital transfers)
- Improve transitions between inpatient hospitals and nursing facilities (including communication, information sharing, medication reconciliation, discharge planning, and follow-up care)
- Reduce overall health care spending, without restricting residents' access to care or limiting their choice of providers
Does CMS expect cost savings to come from limiting access to care?
No. CMS explicitly states that any reductions in spending are intended to come from better care and fewer preventable crises, not from restricting access to medically necessary services or limiting resident choice of providers.
Which residents are the primary focus of the interventions?
The interventions are primarily aimed at long-stay residents who are enrolled in both Medicare and Medicaid (dual-eligible) and who live in Medicare/Medicaid-certified nursing facilities.
Why does the initiative emphasize long-stay nursing facility residents?
CMS emphasizes long-stay residents because they are more likely to experience recurring clinical complications and are at higher risk for avoidable transfers compared with short-stay post-acute residents who typically stay briefly after hospitalization and then return home.
What kinds of strategies or activities are expected under this initiative?
Based on the announcement, CMS expected implementation of enhanced care coordination and clinical strategies designed to improve outcomes and reduce unnecessary hospital use. Transition-focused activities commonly include:
- Improved communication and information sharing between hospitals and nursing facilities
- Medication reconciliation
- Discharge planning
- Follow-up care after transitions
Where will the interventions be implemented?
Interventions are intended for implementation in Medicare- and Medicaid-certified nursing facilities.
How much funding did CMS estimate would be available?
CMS estimated a total of $128,000,000 available for this initiative.
How many awards did CMS expect to make?
CMS expected to make approximately 7 awards.
What is the expected funding range per award?
Projected individual awards ranged from a floor of $5,000,000 to a ceiling of $30,000,000.
Is there a cost-sharing or matching requirement?
No. The opportunity states there was no cost-sharing or matching requirement.
When was this opportunity posted and when did it close?
- Posted date: March 15, 2012
- Created date: April 30, 2012
- Original and current closing date: June 14, 2012
- Archive date: July 14, 2012
Who is eligible to apply?
Eligibility is framed around being an enhanced care coordination provider, meaning an organization capable of implementing the clinical and coordination interventions CMS sought. CMS indicated it would consider applications from a broad range of organizations that can demonstrate operational capacity, clinical capability, and coordination experience.
What types of organizations did CMS list as examples of potential applicants?
Examples provided include:
- Organizations providing care coordination, case management, or related services
- Medical care providers such as physician practices
- Health plans (with a caveat; see related FAQ)
- Public or nonprofit organizations such as Aging and Disability Resource Centers
- Area Agencies on Aging
- Behavioral health organizations
- Centers for Independent Living
- Universities and similar entities
- Integrated delivery networks (particularly if they can extend their networks to include nursing facilities not already affiliated)
Can health plans apply, and are Medicare Advantage enrollees included?
Health plans were included among the examples of organizations CMS would consider, with an important caveat: this is not a capitated managed care initiative and does not apply to Medicare Advantage enrollees.
Are nursing facilities allowed to serve as the enhanced care coordination provider?
No. CMS states that nursing facilities themselves are excluded from serving as the enhanced care coordination provider under this cooperative agreement.
Are entities controlled by nursing facilities eligible to serve as the enhanced care coordination provider?
No. CMS excludes entities controlled by nursing facilities from serving as the enhanced care coordination provider.
Are organizations whose primary business is nursing facility or skilled nursing facility services eligible?
No. CMS excludes entities whose primary line of business is delivering nursing facility or skilled nursing facility services from serving as the enhanced care coordination provider.
What basic legal and administrative requirements must applicants meet?
The announcement lists baseline requirements including that applicants must:
- Be recognized as a single legal entity in the state where incorporated
- Have a unique Tax Identification Number designated to receive payment
- Have a governing body able to enter into a cooperative agreement with CMS on behalf of the organization and any participating members or partners
What should applicants do if they have trouble accessing the full announcement?
For access issues, the listing directs applicants to the Grants.gov Contact Center for support by phone or email during standard weekday hours.
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