Health at Home Challenge

Phase 1: Implementation Strategy (April 2026-July 2026)

The goal of Phase 1 is to reward implementation strategies to scale comprehensive services that reach large numbers of higher-need dually eligible and near-dually eligible Medicare and Medicaid beneficiaries through partnerships between advanced community care networks and health care organizations. 

Key components of this strategy should include:

• Estimated number of dually eligible and near-dually eligible Medicare and Medicaid beneficiaries currently served and estimated to be served through the advanced community care network and health care team
• Ability to deliver a set of core services:
  • Community-based navigation
  • Community-based care coordination and care management
  • Community-based care transitions
  • Evidence-based health promotion programs
  • Nutrition services
• Geographic reach of network partners that support volume and type of services delivered (e.g., statewide or multi-state)
• Technology assets and a shared leadership/governance structure that supports community-clinical integration and the ability to scale to reach a broader geography or larger volume of individuals
• Timeline for full implementation of strategy

Prizes for Phase 1

A total of up to $2 million in prizes will be awarded to a maximum of 10 teams that best meet the judging criteria.
 

Phase 2: Implementation Accelerator (August 2026-July 2027)

The goal of Phase 2 is to accelerate implementation of the winning strategies selected in Phase 1. 

Prizes for Phase 2

A total of up to $2 million in prizes will be awarded to a maximum of five teams that best meet the judging criteria.

Up to three prize winners could be eligible for an additional meritorious prize of up to $50,000 for one of the following focus areas:

• Implementation of AI to enable community-clinical integration and coordinated service delivery for dually eligible and near-dually eligible beneficiaries
• Innovative approaches to reach the near-dually eligible beneficiaries with complex needs and at risk for spend down to Medicaid eligibility
   

Phase 3: Scaling for Impact (August 2027-July 2028)

The goal of Phase 3 is to demonstrate the scaling and impact of the winning teams’ interventions selected in Phase 2. 

Prizes for Phase 3

A total of up to $2 million in prizes will be awarded to a maximum of three teams that best meet the judging criteria.

Up to three prize winners could be eligible for additional meritorious prizes of up to $50,000 for:

• Implementation of AI to enable community-clinical integration and coordinated service delivery for dually eligible and near-dually eligible beneficiaries
• Innovative approaches to reach the near-dually eligible beneficiaries with complex needs and at risk for spend down to Medicaid eligibility

Optional Intent to Apply

Teams are encouraged to submit an optional Intent to Apply by Friday, May 15, 2026, at 5:00 p.m. ET via email to healthathome@acl.hhs.gov. The email should provide all and only the following information:

• Team name, team members, and primary contact information
• A brief description of the proposed community care network-health care partnership and services to reach the target population (maximum 500 words)

Submitting teams must designate a CCH representative as the primary point of contact for the submissions. The primary point of contact for each submission must be a U.S. citizen or permanent resident who is 18 or older. The primary point of contact will be responsible for all correspondence regarding this Challenge. 

All information submitted as part of the Intent to Apply is considered tentative and draft. The information submitted may change before the final submission. 

Phase 1 Submissions

Submissions are due by Wednesday, June 24, 2026, at 5:00 p.m. ET. The designated primary point of contact must submit the completed materials by emailing them to healthathome@acl.hhs.gov no later than the stated deadline.

Submission Requirements

Submissions for Phase 1 of the Challenge shall meet the following requirements. All submissions must:

• Address the information described in the submission outline.
• Be written in English and use clear, straightforward, and concise language. 
• Be submitted in PDF or Microsoft Word format.
• Not exceed 15 pages in length, excluding appendices, which are limited to a total of 10 pages.
• Use 1-inch margins.
• Use a widely available font face (e.g., Arial, Helvetica, Times New Roman, Georgia).
• Use at least 11-point font, except for charts and tables, which must be at least 9-point font.
• Not use U.S. Department of Health and Human Services (HHS), ACL, or other government logos or official seals in their submission or otherwise imply federal government endorsement.

Submission Outline

Cover Page and Contact Information

• Full name of organization acting as the Team lead 
• Mailing address including city, state, zip code
• Primary contact name
• Primary contact telephone number (including area code)
• Primary contact email address
• Project title

Section 1: Demonstration of Need and Responsiveness

Detail how your implementation strategy clearly meets the goals of the Challenge. Namely, it should:

• Demonstrate how committed teams of advanced community care networks and health care partners can integrate the delivery of comprehensive, person-centered services to improve the affordability of high-quality care and independence at home for a large population of dually eligible and near-dually eligible Medicare and Medicaid beneficiaries.
• Address the barriers to sustainable community-clinical partnerships, including lack of infrastructure, workflow integration, referral volume, and braiding of available funding sources for services.
• Demonstrate how trusted networks of aging and disability CBOs, supported through community care hubs, can be responsive to and scale to meet the needs of duals and near-duals, consistent with the service area of their health care partners.

Section 2: Commitment of Health Care Partners

Describe the commitment and collaboration across one or more CCHs and at least one health care partner. A letter of commitment from the health care partner should also be included with your submission.

Section 3: Competency as an Advanced Community Care Network

Describe the competencies of the advanced community care network, represented by its ability to:

• Contract with health plans, health systems, or accountable care organizations.
• Serve a large geographic area with reach that can be regional, statewide, or multistate.
• Maintain the capacity to serve large volumes of people across its networks.
• Provide a diverse set of community-based services to advance health and well-being.
• Maintain a robust infrastructure that supports scaling resources and services while reducing operational costs.  
• Demonstrate high performance through strong technology and data systems that enable impact measurement and outcomes reporting.

Section 4: Capacity to Deliver Core Services at Scale

Describe the demonstrated capacity to deliver core services at scale across the advanced community care network, including:

• Documentation of existing service delivery to the target population of individuals dually eligible for Medicare and Medicaid, as well as those near-dually eligible.
• Availability of trained and qualified staff to deliver core services.
• Established network partners with the capacity to deliver services at scale.

Section 5: Geographic Areas of Interest

Identify the area of interest represented by the advanced community care network-health care partnership. If the Challenge submission is not on the list of target geographies, describe how it demonstrates a high level of readiness and opportunity to address Challenge goals consistent with the factors used to identify these geographies. These factors include:

• Presence of advanced community care networks that are partnering with health care organizations.
• Market penetration of Medicare Advantage, Special Needs Plans, and Medicare Accountable Care Organizations.
• Alignment with CMS Star rating gaps and opportunities for quality improvement.

Section 6: Estimated Reach

Provide an estimated reach, including rationale, of the proportion of dually eligible and near-dually eligible beneficiaries in your state or broader geography (i.e., up to 100,000 individuals served).

Judging Criteria (Phase 1 – Implementation Strategy)

A diverse panel of experts with competencies in aging and disability services, CCHs, Medicare and Medicaid, and health care financing and contracting will evaluate all submissions in each phase of the Challenge. The evaluation team will include both governmental and non-governmental representatives.

Judges will evaluate the extent to which submissions meet the following requirements.

Section 1: Demonstration of Need and Responsiveness

Does the implementation strategy clearly meet the goals of the Challenge? Namely, does it:

• Demonstrate how committed teams of advanced community care networks and health care partners can integrate the delivery of comprehensive, person-centered services to improve the affordability of high-quality care and independence at home for a large population of dually eligible and near-dually eligible Medicare and Medicaid beneficiaries?
• Address the barriers to sustainable community-clinical partnerships, including lack of infrastructure, workflow integration, referral volume, and braiding of available funding sources for services?
• Demonstrate how trusted networks of aging and disability CBOs, supported through community care hubs, can be responsive to and scale to meet the needs of duals and near-duals, consistent with the service area of their health care partners?

Section 2: Commitment of Health Care Partner(s)

Does the implementation strategy represent collaboration across one or more CCHs and at least one health care partner, including a letter of commitment from the health care partner(s)?

Section 3: Competency as an Advanced Community Care Network

Does the lead applicant possess the requisite competencies of an advanced community care network, represented by its ability to:

• Contract with health plans, health systems, or accountable care organizations?
• Serve a large geographic area with reach that can be regional, statewide, or multistate?
• Maintain the capacity to serve large volumes of people across its networks? 
• Provide a diverse set of community-based services to advance health and well-being?
• Maintain a robust infrastructure that supports scaling resources and services while reducing operational costs?  
• Demonstrate high performance through strong technology and data systems that enable impact measurement and outcomes reporting?

Section 4: Capacity to Deliver Core Services at Scale

Is there demonstrated capacity to deliver core services at scale across the advanced community care network, including:

• Documentation of existing service delivery to the target population of individuals dually eligible for Medicare and Medicaid, as well as those near-dually eligible?
• Availability of trained and qualified staff to deliver core services?
• Established network partners with the capacity to deliver services at scale?

Section 5: Geographic Areas of Interest

Does the advanced community care network-health care partnership represent one or more of the identified areas of interest or does it demonstrate a high level of readiness and opportunity to address Challenge goals consistent with the factors used to identify these areas? These factors include:

• Presence of advanced community care networks that are partnering with health care organizations
• Market penetration of Medicare Advantage, Special Needs Plans, and Medicare Accountable Care Organizations
• Alignment with CMS Star rating gaps and opportunities for quality improvement

Section 6: Estimated Volume of Individuals Dually Eligible for Medicare and Medicaid and Near-Duals 

Does the implementation strategy reflect an estimated reach to a significant proportion of dually eligible and near-dually eligible beneficiaries in their state (i.e., up to 100,000 individuals served)?

Eligibility

To be eligible to win a prize, the Challenge team:

• Shall have complied with all the requirements under this section.
• Must represent a partnership between an advanced community care network and at least one health care organization. Multiple CCHs can collaborate on a submission, but one CCH must be designated as the Challenge team lead. This CCH must be connected to an area agency on aging, an aging and disability resource center, a center for independent living, or another aging or disability network organization. 
• Must include with their submission a commitment letter from at least one health care partner, as well as any key community partners as relevant.  
• Must agree to participate in an external evaluation to measure the impact of services delivered to dually eligible and near-dually eligible beneficiaries as a condition to progress to subsequent phases if awarded in Phase 1.
• Shall, in the case of a private entity, be incorporated in and maintain a primary place of business in the U.S. In the case of a team, the team leader shall be a U.S. citizen or permanent resident. However, non-U.S. citizens and non-permanent residents can participate as members of a team or entity that otherwise satisfies the eligibility criteria. Non-U.S. citizens and non-permanent residents are not eligible to win a monetary prize (in whole or in part). Their participation as part of a winning team or entity, if applicable, may be recognized at the announcement of the results. In the case of an individual, whether participating singly or in a group, they shall be a citizen or permanent resident of the U.S.
• Shall not be a federal entity or federal employee acting within the scope of their employment (all non-HHS federal employees must consult with their agency ethics official to determine whether the federal ethics rules will limit or prohibit the acceptance of a COMPETES Act prize).
• Shall not be an employee of (HHS) or any other component of HHS acting in their personal capacity.
• Shall not be a judge of the Challenge, or any other party involved with the design, production, execution, or distribution of the Challenge or the immediate family of such a party (i.e., spouse, parent, stepparent, child, or stepchild).
• May, in the case of federal grantees, not use federal funds to develop submissions unless consistent with the purpose of their grant award.
• May, in the case of federal contractors, not use federal funds from a contract to develop COMPETES Act challenge submissions or fund efforts in support of a COMPETES Act challenge submission.
• Shall be 18 years of age or older at the time of submission.

Participation Requirements

• An individual, entity, or team shall not be deemed ineligible because the individual or entity used federal facilities or consulted with federal employees during a competition if the facilities and employees are made available to all individuals and entities participating in the competition on an equitable basis.
• Federal grantees and recipients of cooperative agreements may not use federal funds to develop their Challenge submissions unless use of such funds is consistent with the purpose of their grant award and specifically requested to do so due to the Challenge design. If a participant uses federal grant or cooperative agreement funds to win the Challenge, the prize must be treated as program income for purposes of the original grant or cooperative agreement in accordance with applicable Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards [2 CFR § 200].
• Multiple entries are permitted. Each solution must be sufficiently novel and unique and not be a minor modification of a prior submission.
• By participating in this Challenge, each participant (whether a team or entity) agrees to assume any and all risks and waive claims against the federal government and its related entities, except in the case of willful misconduct, for any injury, death, damage, or loss of property, revenue, or profits, whether direct, indirect, or consequential, arising from participation in this prize contest, whether the injury, death, damage, or loss arises through negligence or otherwise.
• Participants are required to obtain liability insurance or demonstrate financial responsibility for claims by a third party for death, bodily injury, or property damage, or loss resulting from an activity carried out in connection with participation in this Challenge.
• Participants must also agree to indemnify the federal government against third-party claims for damages arising from or related to Challenge activities.
• By participating in this Challenge, each participant (whether a team or entity) warrants that they are sole author or owner of, or has the right to use, any copyrightable works that the submission comprises, that the works are wholly original with the participant (or is an improved version of an existing work that the participant has sufficient rights to use and improve), and that the submission does not infringe any copyright or any other rights of any third party of which the participant is aware.
• As a condition for winning a cash prize in this Challenge, each participant (whether participating as a team or entity) grants to ACL an irrevocable, paid-up, royalty-free nonexclusive worldwide license to reproduce, publish, post, link to, share, and display publicly the team/entity name, title, executive summary, and plain language summary components of the submission on the web or elsewhere. Each participant will retain all other intellectual property rights in their submissions, as applicable. To participate in the Challenge, each participant must warrant that there are no legal obstacles to providing the above-referenced nonexclusive licenses of the participant’s rights to the federal government.
• Each participant (whether a team or entity) agrees to follow all applicable federal, state, and local laws, regulations, and policies.
• Contestants to this Challenge must agree to be bound by the rules of the Challenge, agree that the decision of the judges for this Challenge are final and binding, and acknowledge that their submission may be the subject of a Freedom of Information Act (FOIA) request and that they are responsible for identifying and marking all business confidential and proprietary information in their submission.
• As a condition for winning a cash prize in this Challenge, each participant (whether participating as a team or an entity) irrevocably grants to ACL the right to the use of their name, affiliation, city and state, and likeness or image for publicity releases and any other promotion of this Challenge.
• Submitting teams are only eligible to compete for Phases 2 and 3 of the Challenge if they are selected as a winner in the previous phase. Only Phase 1 winners are eligible for Phase 2; only Phase 2 winners are eligible for Phase 3. ACL reserves the right to cancel, suspend, and modify the Challenge, or any part of it, for any reason, at ACL’s sole discretion.

Awarding the Prize 

Prizes awarded under this Challenge will be paid via electronic funds transfer and may be subject to federal income taxes. HHS and ACL will comply with the Internal Revenue Service (IRS) withholding and reporting requirements, where applicable.

Entities participating in this Challenge are encouraged, but not required, to request and obtain a free Unique Entity ID (UEI), if they have not already done so, via SAM.gov,as this will expedite prize payment.

For team submissions, if a cash prize is awarded, the prize will be paid in full to the designated team leader, who is solely responsible for distributing the prize funds among team members.  

For entity submissions, if a cash prize is awarded, the prize will be paid directly to the entity and not the entity’s point of contact. HHS and ACL will not arbitrate, intervene, advise on, or resolve any disputes or arrangements among team members. 

Statutory Authority to Conduct the Challenge 

ACL is conducting this Challenge under the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education, and Science (COMPETES) Reauthorization Act of 2010, as amended, 15 U.S.C. § 3719, and the Older Americans Act at 42 U.S.C. § 3012(a)(31) and (b)(8) for the types of activities the prize is intended to incentivize.