Transforming Maternal Health (TMaH) Model - FY 2024
| Agency: | U.S. Department of Health and Human Services |
|---|---|
| CFDA: | 93.869 |
| Federal FON: | CMS-2N2-25-001 |
| Office: | Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation |
| Multipart Grant: | No |
| Next Due: | 09/20/2024 (Application) |
|---|---|
| Solicitation Date: | 06/26/2024 |
| Match Required: | No |
| Actual Funds: | $255,000,000 (Estimated) |
| Award Range: | $17,000,000 (Max) |
Summary:
The purpose of this program is to support the implementation of the TMaH model, which is designed to improve maternal health outcomes for people enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The program will test whether targeted technical assistance (TA), coupled with payment and delivery system reforms, can drive a whole-person care-delivery approach to pregnancy, childbirth, and postpartum care while reducing Medicaid and CHIP program expenditures.
The goals of the TMaH model are:
- Reduced rates of low-risk cesarean sections (c-sections)
- Reduced incidence of severe maternal morbidity
- Reduced rates of low-birthweight infants
- Improved experience of perinatal care
- Reduced Medicaid and CHIP program expenditures for maternity and infant care
The three pillars of the MaH model, as well as the required elements of the model are:
- Pillar one: access, infrastructure, and workforce:
- Increase access to the midwifery workforce
- Increase access to birth centers
- Cover doula services
- Improve data infrastructure
- Develop payment model
- Pillar two: quality improvement and patient safety:
- Support implementation of Alliance for Innovation on Maternal Care (AIM) patient safety bundles
- Support "birthing-friendly" hospital designation
- Pillar three: whole-person care delivery:
- Increase risk assessments, screenings, referrals, and follow-up for perinatal depression, anxiety, tobacco use, substance use disorder, and health-related social needs (HRSNs)
- Increase home monitoring of diabetes and hypertension
- Develop health equity plans
Refer to pages 7-24 of the NOFA file for detailed information regarding the TMaH model.
The model will consist of a three-year pre-implementation phase and a seven-year implementation phase. Pre-implementation funding and TA will help recipients build critical skills and capacity to successfully launch a value-based payment model that supports delivery of whole-person care during the seven-year implementation period.
Participation in the project will require significant effort, collaboration, and staff time from award recipients to set the foundation for success, given the historic underinvestment in maternal health care. Recipients will work, and will be required to recruit, partner providers, partner care delivery locations, and other partner organizations.
All award recipients:
- Must work with the funding agency in the first two years of the project period to develop and implement a detailed TA and tailored work plan with defined tasks, timelines, and benchmarks that will support achievement of model elements
- Must use a portion of their awards to provide financial assistance to providers for care delivery transformation activities (provider infrastructure payments), no later than the final year of the pre-implementation period
- May receive retrospective performance payments on a set of quality and cost measures, in the fourth year of project periods
- Transition to a new value-based payment model to be finalized during the pre-implementation period, by year five of the project period
Funding may be used for:
- Recruitment and partnership
- Model development
- Health information technology (IT), data, and infrastructure
- Personnel
- Partner providers
Refer to page 48 and pages 78-86 of the NOFA file for details regarding allowable costs.
Optional webinars are expected to be scheduled for this program. Optional office hour sessions are also scheduled for this program. Refer to the Application section for details.
Last Updated: August 27, 2024
Eligibility Notes:
Eligible applicants are the state Medicaid agencies (SMAs) for the 50 states, American Samoa, District of Columbia, Guam, Commonwealth of the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
Applicants must propose either to implement the model statewide or to implement the model in a substate region specified by ZIP codes. Regardless of the size of the chosen implementation area, the average number of combined Medicaid- and Children's Health Insurance Program (CHIP)-covered births between calendar years 2015 and 2020 must be at least 1,000 per year for the region. Substate implementation is strongly preferred.
The funding agency encourages applicants to include rural, underserved, and tribal areas in their proposed test regions, where appropriate.
Each applicant may submit only one application.
Refer to page 35 of the NOFA file for information regarding the eligibility of activities that involved overlaps of the program's model and other models.
Faith-based organizations, other organizations, and businesses are not eligible to apply.
Eligible Applicants:
State GovernmentApplication Notes:
Applications must be received by 11:59 p.m. ET on September 20, 2024.
Applications must be submitted online at www.ecivis.com/grants.gov.
Applications must include:
- SF 424
- SF 424A
- SF LLL
- Project site location form
- Project abstract summary (1 page max)
- Cover letter or cover page (optional)
- Project narrative (60 pages max)
- Budget narrative (10 pages max)
- Appendices (20 pages max):
- Resumes and/or curriculum vitae
- Job description for key personnel
- Organization chart
- Letters of support (optional)
- Business assessment of applicant organization (12 pages max)
- Program duplication assessment (10 pages max)
Applications must be typed on standard-sized, one-sided pages with one-inch margins, using a font size that is at least 12-point in size. All pages of the project and budget narratives must be paginated in a single sequence. The project narrative must be double-spaced. The project abstract summaries and budget narratives may be single-spaced. Tables may also be single-spaced.
The following are required in order to submit an application:
- Unique Entity Identifier (UEI) number
- SAM (System for Award Management) registration
Applicants may obtain a UEI number and verify or renew SAM registration status at www.ecivis.com/sam.
Optional letters of intent (LOIs) must be received by 11:59 p.m. ET on August 8, 2024. LOIs must be emailed to the address provided in the Contact section.
The funding agency will host one or more webinars for this program prior to the application deadline. Additional information will be posted online at www.cms.gov.
Optional office hour sessions for this program are also scheduled as follows:
August 21, 2024
1:00 - 2:00 p.m. ET
Registration: deloitte.zoom.us
September 12, 2024
2:00 - 3:00 p.m. ET
Registration: deloitte.zoom.us
A recording of a webinar held for this program, as well as an office hour session, can be found online at www.cms.gov/priorities/innovation.
Applications will be evaluated using the following criteria:
- Maternal health policy priorities (5 points)
- Organization, administration, and capacity (7 points)
- Payment environment (5 points)
- Regional plan (15 points)
- Model pillars (30 points)
- Sustainability plan (9 points)
- Stakeholder recruitment (9 points)
- Budget narrative (20 points)
Refer to the NOFA file for additional application information.
| Match Required: | No |
|---|---|
| Actual Funds: | $255,000,000 (Estimated) |
| Award Range: | $17,000,000 (Max) |
|---|
Match Notes:
Matching funds are not required for this program.
Funding Notes:
An estimated $225 million is expected to be available to support approximately 15 cooperative agreements of up to $17 million each through this program.
In addition to monetary awards, recipients will receive technical assistance (TA) from the funding agency to build critical skills and capacity to successfully launch a value-based payment model. TA will be provided in the form of peer-to-peer collaborative learning opportunities and one-on-one assistance. Refer to pages 29-30 of the NOFA file, as well as the TAFactSheet file, for details.
Notices of awards are expected to be issued on January 13, 2025.
The project period is anticipated to begin on January 20, 2025, and end on January 19, 2035. Award recipients will be expected to participate in all ten years of the project period. The first three years will be the pre-implementation phase, and the final seven years will be the implementation phase. Recipients will receive up to $8 million during the pre-implementation phase and up to $9 million during the implementation phase. Refer to page 33 of the NOFA file for details. Continued funding throughout the project period is contingent upon project performance and funding availability.
Beginning no later than the final year of the pre-implementation phase, award recipients must use a portion of their awards to provide financial assistance to providers for care delivery transformation activities. Refer to pages 6-7 and 13-27 of the NOFA file for additional information regarding details of the program's timeline and delivery milestones.
Funds may not be used for:
- Model year 4 upside-only performance payments to be paid by recipients
- Pre-award costs
- Matching other federal funds or local entity funds
- Services, equipment, or supports that are the legal responsibility of another party under federal, state, or tribal law; or under any civil rights laws
- Goods or services not allocable to the approved project
- Supplanting existing state, local, tribal, or private funding of infrastructure or services, such as staff salaries
- Construction
- Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life as a direct cost, except with the prior written approval of the funding agency
- Cost of independent research and development, including their proportionate share of indirect costs
- Any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before the Congress or any state government, state legislature, or local legislature or legislative body
Refer to pages 53-54 of the NOFA file for additional details regarding unallowable costs.
Contacts:
Program Staff
tmahmodel@cms.hhs.gov
Agency Address
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
Contact Notes:
Questions should be directed to the program staff. Questions should reference "NOFO Inquiry" in the subject line. A list of frequently asked questions may be posted online at www.cms.gov.
Applications must be submitted online at www.ecivis.com/grants.gov.
Optional letters of intent must be emailed to the address provided.
The agency address provided is for reference purposes only.
Files:
NOFA File: US17932_NOFA_FY2024.pdf (1.6 Mb)Other Pre-Award File: US17932_FactSheet_FY2024.pdf (282.4 Kb)
Other Pre-Award File: US17932_TAFactSheet_FY2024.pdf (261.4 Kb)
Other Pre-Award File: US17932_FAQ_FY2024.pdf (228.5 Kb)
Other Pre-Award File: US17932_WebinarPresentation&Transcript_FY2024.zip (1.1 Mb)
Other Pre-Award File: US17932_OfficeHours_FY2024.pdf (127.0 Kb)
Other Pre-Award File: US17932_OfficeHourPresentation_FY2024.pdf (563.5 Kb)
Other Pre-Award File: US17932_OfficeHourTranscript_FY2024.pdf (286.0 Kb)
File Notes:
The NOFA file contains the full solicitation for this program. The FactSheet file contains a general overview of the program. The TAFactSheet file contains a general overview of technical assistance that will be provided to award recipients. The FAQ file contains a list of answers to frequently asked questions regarding this program. The WebinarPresentation&Transcript folder contains the presentation slides and a transcript for a webinar held for this program. The OfficeHours file contains information regarding optional office hour sessions that are scheduled for this program. The OfficeHourPresentation file contains slides from an office hour session held for this program. The OfficeHourTranscript file contains a transcript of an office hour session held for this program. Additional program resources can be found online at www.cms.gov.
August 28, 2024
A recording of an office hour session has been released, and a link to the presentation is available in the Application section. Presentation slides and a transcript for the session have also been released and attached as the OfficeHourPresentation and OfficeHourTranscript files, respectively. The Application section has been updated accordingly.
August 7, 2024
Information regarding optional office hour sessions that are scheduled for this program has been released and attached as the OfficeHours file. In addition, a recording of a webinar has been released, and a link to the presentation is available in the Application section. Presentation slides and a transcript for the webinar have also been released and attached as the WebinarPresentation&Transcript folder. The Application section has been updated accordingly.
Grant Keywords
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Training & Vocational ServicesHealth, Prevention/Treatment
Health, Research
Human Services