In 2025, Optum Care Network PNW will be offering grant funding to support network practices in developing and implementing innovative projects that improve the quality or efficiency of patient care.

Eligibility Criteria

• Primary care and specialty practices in Washington and Oregon contracted with OCN for serving Medicare Advantage members (both WA and OR) and/or Medicaid members (WA only) as of the application deadline.
• At least one provider from the practice must attend the OCN PNW Grant Program event in 2026. Provider must be willing to present on their project if asked.

Grant Criteria

Practices may utilize grants for the following value-based care activities:

• Coordinating and managing care of OCN Medicare Advantage membership (both WA and OR) and/or OCN Medicaid membership (WA only).
• Improving the quality of care of OCN Medicare Advantage membership (both WA and OR) and/or OCN Medicaid membership (WA only).
• Appropriately reducing the costs to payors or growth in expenditures of payors without reducing the quality of care for OCN Medicare Advantage membership (both WA and OR) and/or OCN Medicaid membership (WA only).
• Transitioning from health care delivery and payment mechanisms based on the volume of items and services provided to mechanisms based on the quality of care and control of costs of care for OCN Medicare Advantage membership (both WA and OR) and/or OCN Medicaid membership (WA only).

Grants may not:

• Be for the purpose of any marketing to patients to utilize the practice or OCN.
• Take into account the volume or value of referrals or be conditioned as a payment for referrals of patients or business not otherwise covered by the full-risk Medicare Advantage contract (both WA and OR) or Medicaid contract (WA only).
• Be used for salaries, staff time, equipment or upgrades needed for basic operations.
• Be used for any non-grant awarded purpose.

Grants are subject to a formal written agreement signed by all parties detailing the activities the practice will perform under the grant.

Funding Guidelines

To obtain funding, practices must provide a detailed and itemized funding request. Please include estimates for all costs needed to implement the program and the assumptions used to create the grant funding request.

The maximum funding amount is $15,000 for 2025. Practices may apply for multiple grants, however combined funds requested must be within the maximum funding amount.

Project Guidelines

• Projects must be new to the clinic and approach a problem or gap in a new and innovative way (departure from existing workflows).
• Project outcomes must be measurable based on initial baseline and final data.
• Project must be sustainable after initial funding and replicable by other practices.
• All clinic staff and physicians must be aware of the project, supportive of its goals, and committed to its implementation.

Program Process

1.    Grant application form will be sent to contracted practices on January 14, 2025. Application form (located here) includes the following information:

• Practice name and TIN
• Project contacts, including a physician champion
• Description of project, including desired outcome or goal
• Explanation of how the project addresses a problem or barrier to either access or delivery of care
• Implementation milestones in quarterly intervals
• Baseline data and description of how outcomes will be measured
• Total requested grant funding
• Estimated materials costs with breakdown for all material items
• Assumptions used to establish material costs
• Explanation of how funding will be used with anticipated impact to quality, patient experience, or cost of care
• Description of how project will be sustained after initial funding

2.    The application process closes on February 14, 2025. The OCN PNW Grant Committee will review and make a decision all proposals. Practices will receive notice of decision by March 3, 2025.

3.    Practices will be sent the “Value Based Arrangement Grant Agreement” for signature upon approval. One upfront grant payment will be issued to the practice in March of 2025, contingent upon OCN receipt of the signed agreement.

4.    Practices must submit a mid-year report by July 31, 2025. Recoupment of funds may be pursued at this time if there is a lack of response or engagement. Mid-year report must contain the following:

• Description of key project goals and results year-to-date
• Description of the implementation experience for staff and patients year-to-date
• Description of delays or obstacles the project faces and how they are being addressed
• Documentation of spending or other financial information may be requested at this time

5.    Practices must submit a final report by December 31, 2025. The final report must contain the following:

• Description of key project goals and final results
• Description of the implementation experience for staff and patients
• Description of delays or obstacles the project faced and how they were addressed
• Description of how the project will be sustained
• Documentation of spending or other financial information may be requested at this time

6.    The OCN PNW Grant Program event which will include a review of 2025 projects will be held in Q2 of 2026. These events provide an opportunity for practices to share project outcomes, best practices, and lessons learned. At least three practices will be asked to present an overview of their project and its results at the event.

Primary Care Practice can reach out to their Practice Engagement Manager or Network Medical Director for more information on participating in the 2025 OCN PNW Grant Program.

For Specialty Care Practices please reach out to Liz Farrell – liz.farrell@optum.com