CMS-2W2-27-001
Make America Healthy Again – Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence
Summary
MAHA ELEVATE: Funding Opportunity Briefing
Research Focus
The Make America Healthy Again: Enhancing Lifestyle & Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) program tests whole-person functional and lifestyle medicine (FLM) interventions integrated with conventional care for Original Medicare beneficiaries. The model targets chronic disease prevention and management through evidence-based behavioral interventions—specifically nutrition, physical activity, stress management, sleep hygiene, substance avoidance, and social connection—rather than reactive symptom treatment. CMS seeks to generate rigorous evidence on whether these proactive, systems-based approaches improve health outcomes and reduce Medicare spending, potentially informing future coverage decisions or full-scale implementation.
At-a-Glance
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Who can apply: Organizations (not individuals) including health systems, ACOs, academic institutions, functional/lifestyle medicine centers, community-based organizations, FQHCs, rural health clinics, tribal services, and local/state governments. Must demonstrate prior experience integrating whole-person FLM into conventional care with documented health and cost improvements.
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Funding & project length: Up to $3.3 million per recipient over 3 years; total program investment up to $100 million across up to 30 awards (two cohorts of 15 each, one year apart).
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Award mechanism: Cooperative agreement (substantial CMS involvement in project planning, monitoring, and evaluation).
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Key dates: Letter of intent due April 10, 2026; applications due May 15, 2026 (11:59 p.m. ET); awards expected October 2026.
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Best fit for: Health systems, primary care practices, and preventive medicine organizations with existing FLM programs targeting Medicare beneficiaries; strong candidates combine nutrition or physical activity interventions with randomized study designs and demonstrated prior cost savings.
Key Facts
Deadline
Fri, May 15, 2026
Posted
Fri, March 13, 2026
Award / Year
$1,100,000
Max Duration
3 years
Expected Awards
15
Keywords
Research Areas
Gotchas (19)
Missing even one operational milestone (60% of funding) results in forfeiture of all future disbursements. This is an all-or-nothing structure where a single missed deadline triggers loss of remaining
98%
Source Text
“The majority of your award—60% —depends on meeting operational milestones by specific deadlines outlined in Table E. You must hit all these targets on time to receive this funding; should an organization miss a milestone, they forego eligibility for all future disbursements.”
If an organization has not enrolled at least 20% of minimum beneficiary target by 20 months post-award, the award may be terminated. At 32 months, failure to reach 65% of target triggers potential ter
95%
Source Text
“*At 20 months, if you have not reached 20% of your minimum beneficiary target, your award may be terminated. **At 32 months, if you have not reached 65% of your minimum beneficiary target, your award may be terminated.”
New/Early-Stage Investigator Restriction
100%
Source Text
“Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) Model. This voluntary, three-year service delivery model is designed to test evidence-based, whole-person functional or lifestyle medicine (“whole-person”
Letter of Intent (LOI) is required before submitting a full application, with a separate deadline of April 10, 2026—over one month before the application deadline of May 15, 2026. This is a mandatory
95%
Source Text
“Required letter of intent Due by Friday, April 10, 2026. A letter of intent (LOI) is required if you are interested in applying for this opportunity. Prior informal expressions of interest, including but not limited to emails or other correspondence submitted before publication of this NOFO, do not satisfy this requirement and will not be considered as valid LOI submissions.”
Organizations must demonstrate prior experience integrating whole-person FLM into conventional medical care with demonstrated improvements in health, quality, and costs. This is a prerequisite eligibi
90%
Source Text
“Organizations must have experience integrating whole-person FLM into conventional medical care, resulting in demonstrated improvements in health, quality, and costs.”
Non-HIPAA covered entities must obtain valid HIPAA-compliant patient authorizations from each prospective patient and submit them to CMS for approval before enrolling the patient. Failure to do so may
95%
Source Text
“Any organization that is not a covered entity or business associate of a covered entity under HIPAA must obtain a valid patient authorization that meets the HIPAA authorization requirements set forth in 45 C.F.R. § 164.508 to enable CMS to share any PHI with the applicable organization. The organization will need to receive a completed HIPAA compliant authorization from each prospective patient and submit it to CMS for approval before enrolling the patient in the cooperative agreement program. F”
Applicants must demonstrate randomization or a valid comparison group design. The scoring criteria explicitly state: 'Any applicant that does not ultimately put forward a plan to randomize or construc
95%
Source Text
“Study Design: Your study design meets one of the following: • Achievable randomization plan: 10 of 10 points. • Randomized delayed enrollment for some patients to create a control group: 8 of 10 points. • Other plans to create a comparison group: 4 to 7 of 10 points. • No randomization or comparison group: 0 of 10 points. As part of its implementation contract, CMS or its contractor may support study design improvements for otherwise promising applications. NOTE: Any applicant that does not ult”
If patient enrollment has not begun by 12 months post-award, the entire award may be terminated. This is a hard deadline for starting enrollment activities.
95%
Source Text
“You may use up to six months for pre-implementation activities at the start of the award. For example, you might use this time to build referral networks with partners. After six months, you should start enrolling patients into your program. If you haven't started enrolling patients by 12 months post-award, your award may be terminated.”
Cost Sharing / Matching Required
100%
Source Text
“• Independent merit: Each proposal must demonstrate individual merit and scientific value worthy of separate testing and evaluation. Cost sharing This program has no cost-sharing requirement, meaning you do not need to”
Unusual Budget Limitations
100%
Source Text
“• The cost of independent research and development, including their proportionate share of indirect costs. See 2 CFR 300.477 . • Funds related to any activity designed to influence the enactment of”
Preliminary Data Required
100%
Source Text
“drop by ___% within 6 months of starting the program. This estimate is based on pilot data from a similar study using a quasi-experimental design [citation]. Example 2: Within one year, we expect total Medicare FFS”
Meals and food cannot be funded by the cooperative agreement, even as part of nutrition interventions, though other funding sources may be used
92%
Source Text
“Meals, food, or vouchers for meals or food. Please note: You may use other funding sources to provide food, meals, or vouchers as part of your program. Meals as part of a per diem allowance provided in conjunction with allowable travel are allowable.”
Laboratory tests must be conducted in CLIA-certified laboratories; non-certified labs cannot be used even for data collection
90%
Source Text
“Laboratory tests conducted in laboratories that do not have CMS Clinical Laboratory Improvement Amendments (CLIA) certification.”
Applicants must attend monthly calls with CMS project or grants management specialist to discuss project progress and challenges. This is a mandatory ongoing engagement requirement that differs from t
85%
Source Text
“Attend monthly calls with the CMS project or grants management specialist to discuss your project's progress and challenges. The meetings will include key personnel and the project officer.”
Dementia and cognitive decline programs have only 3 of 30 total awards set aside, creating very limited funding opportunity for this focus area
90%
Source Text
“Additionally, three out of the 30 total awards are set aside specifically for programs focused on dementia and cognitive decline.”
Organizations participating in multiple CMS Innovation Center models will be assessed for participation on a case-by-case basis, creating uncertainty about whether dual participation is permitted
85%
Source Text
“Organizations accepted to multiple active CMS Innovation Center models will be assessed for participation on a case-by-case basis.”
The NOFO states that CMS will provide funding in up to nine disbursements over three years based on completing milestones in Table E, and also states funding will be provided in two budget periods of
80%
Source Text
“We will provide funding in up to nine disbursements over a three-year period of performance based on completing the milestones for each payment detailed in Table E: Operational Milestones. We will provide funding in two budget periods of 18 months each over a three-year period of performance.”
CMS may require additional documentation regarding partnerships after application submission, creating post-award compliance burden
85%
Source Text
“However, as the applicant, you are not required to be a clinical entity. If you are not a clinical entity, but partner with one, you will need to submit a partnership document as described in the application template. CMS may require the submission of additional documentation regarding the partnership after application submission.”
Non-Standard Page Limit
100%
Source Text
“Make sure that you have everything you need to apply: Narratives Component How to upload Page limit Project summary Use the Project Abstract Summary form. 1 page Project narrative Use the Project Narrative templates.”