The Centers for Medicare and Medicaid Services (CMS) is testing out a new preventative value-based care model with a possible path for nursing homes to get involved – if they have a robust dementia care program, innovative activities programs and dietary services, or a well-aligned clinical model with physicians and nurse practitioners.
But, the model only has room for 30 organizations, and $100 million in funding.
The Notice of Funding Opportunity for the Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence model (ELEVATE) was posted in March, and will begin its first cohort in October 2026 and another in October 2027. The closing date for the first round of applications is May 15 and a letter of intent was due by April 10.
Three awards will be reserved specifically for dementia care, but potential participants are broad, including academic medical centers and community-based organizations, along with nursing homes.
“This is different, right? This is not a CMS Innovation Center model that you apply to, this is a competitive grant program that will be administered through cooperative agreements,” said Brian Fuller, managing director for value-based care design and delivery at ATI Advisory.
The CMS Innovation Center is testing out new ways, through its grant program, to incorporate interventions that are not currently part of Medicare coverage and figure out if such interventions can improve quality and reduce costs, Fuller added.
“They want to demonstrate some evidence through this initial set of recipients, and then do an evaluation and figure out if it makes sense to expand the program or not,” said Fuller.
More broadly, the model will test out lifestyle and functional medicine interventions for chronic disease and focus on approaches not typically covered under traditional Medicare Fee-for-Service.
Eligibility is limited to organizations that deliver or partner to provide functional or lifestyle medicine services, with a goal of complementing conventional medical treatment by addressing broader factors that influence health and long-term outcomes.
Funded interventions will target chronic conditions and include evidence-based strategies related to nutrition, exercise, sleep, stress, and social connection, CMS said. Outcomes are assessed based on patient experience, clinical improvements, reduced hospital use and cost efficiency, all while maintaining oversight to ensure patient safety and quality standards.
Federal grant familiarity
The 30 organizations will have the chance to join across two application periods, Fuller said, meaning this will be a highly competitive program, and organizations will need to be well positioned to apply quickly and be well-versed in applying for and accepting federal grants.
“Do you know what it means to accept a federal grant, what those agreements look like, what the reporting requirements are, what the auditing procedures are for how you take in and distribute and utilize the funds? All of the mechanics and administrative operations of accepting and then running and reporting out on a grant program is very important,” said Fuller.
The grant program will focus on health lifestyles, highlighting nutrition and physical activity as part of the design. Operators with notable activities coordinators or dieticians might stand out.
Proposals for the grant program must document evidence of intervention efficacy – the grant isn’t designed to fund programs that don’t exist yet, but rather programs that are ready to launch at a greater scale and have data to back up efficacy.
“That’s another important caveat and threshold for success in the program,” said Fuller.
Best suited for grants
Operators that have their hands in multiple care settings are better suited to the grant program too, he said, with home health and assisted living services available in addition to nursing home care.
“There are many organizations out there who have home health and other home-based business lines that serve seniors. There are organizations where skilled nursing is part of a broader senior living campus that may have independent living and or assisted living,” said Fuller. “I think those organizations might be well positioned for ELEVATE.”
And of course, operators with a robust dementia program are strongly encouraged to apply, along with those that incorporate well-documented nutrition or lifestyle programs that show positive outcomes.
All of these are entry points for nursing homes to get involved, Fuller said.
“There are aspects of the model that certainly are important to the residents that nursing homes serve,” added Fuller. “Nutrition, physical activity, social connection, emotional well being and behavioral factors, along with dementia, are things that nursing homes have to manage and can become challenges in their populations and certainly impact health outcomes.”
The grant program placed emphasis on having a medical director too – any potential recipient facility that has an aligned clinical model with physicians and nurse practitioners is better positioned for this grant funding.
While there’s a close connection between physiatry and physical function and activity, it remains to be seen whether a partnership with a physiatry group would improve an operator’s chances for the program, Fuller said.
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