Smart Care Catalyst Design and Administer Statewide Multi Payer Payment Models Grant Program

The West Virginia Department of Health, through its Rural Health Transformation Program, has released an Announcement of Funding Availability for the Smart Care Catalyst initiative focused on designing and administering statewide, multi payer value based care payment models. This program is supported by a large federal investment provided through the Centers for Medicare and Medicaid Services under a broader rural health transformation effort totaling approximately 200 million dollars. The initiative is positioned as a central component of the state’s strategy to improve health outcomes, reduce chronic disease burden, and increase workforce participation, particularly in rural and underserved communities. The Smart Care Catalyst specifically emphasizes transitioning healthcare reimbursement from volume based to outcomes based models, with an initial focus on substance use disorder populations in southern regions of the state. The purpose of this funding opportunity is to select one or more qualified entities capable of designing, operationalizing, and administering standardized value based care payment models that can be implemented across multiple payers including Medicaid managed care organizations and other insurers. The funded entity is expected to produce implementation ready model designs, establish comprehensive performance measurement and data sharing frameworks, and coordinate alignment among payers and providers. The initiative prioritizes measurable outcomes over activity, requiring applicants to demonstrate the ability to deliver tangible improvements in health outcomes, utilization patterns, and workforce readiness. The models developed must be scalable statewide and structured to support long term sustainability beyond the initial funding period. Funding for this opportunity totals up to 2.5 million dollars for a one year performance period ending July 31, 2027. Awards may be distributed to one or multiple recipients depending on the quality and feasibility of proposals. Payments are milestone based and contingent upon state approval of deliverables such as model designs, data frameworks, and alignment documentation. An initial advance payment may be provided for startup costs, followed by reimbursement tied to achievement of defined milestones. Administrative costs are capped at ten percent of the total award, and funds must supplement rather than replace existing resources. The program includes strict compliance requirements aligned with federal regulations and prohibits use of funds for activities such as construction, lobbying, or duplicative clinical service payments. Eligible applicants include organizations with demonstrated expertise in value based payment model design and administration, including accountable care organizations, clinically integrated networks, population health management entities, academic institutions, and other organizations with strong analytical and governance capabilities. Applicants must demonstrate the ability to coordinate across payers and providers, integrate with state data systems such as the West Virginia Health Information Network and the state data spine, and support comprehensive reporting requirements. The program requires extensive collaboration with state leadership and other transformation initiatives, with all generated data and deliverables considered state program assets for oversight and integration purposes. Applications must be submitted through the West Virginia OASIS Vendor Self Service portal and include several required components such as a detailed narrative addressing organizational capacity, project impact, feasibility, and sustainability, along with a line item budget, budget narrative, contact list, and county level service plan. Evaluation criteria include organizational capacity, projected impact on health outcomes, feasibility of implementation, long term sustainability, and budget justification. Applications must achieve a minimum score threshold to be considered for funding, and final award decisions will align with state strategic priorities. Key dates include a release date of July 27, 2026 and an application deadline of August 10, 2026 at 11 59 PM Eastern Time. Applicants are encouraged to submit questions within three business days of the posting date, with responses provided through the state system. The program requires ongoing monthly and quarterly reporting, as well as compliance with federal and state oversight processes. Successful applicants will be expected to demonstrate progress through defined milestones and contribute to long term transformation of healthcare delivery through scalable, data driven, and outcome focused payment models.

Emphasize measurable outcomes multi payer alignment and implementation readiness demonstrate strong data integration capabilities and clear governance structures