AHRQ Healthcare Choice and Competition Challenge to Improve Quality, Lower Prices, and Expand Access
Challenge Title
AHRQ Healthcare Choice and Competition Challenge to Improve Quality, Lower Prices, and Expand Access
Tagline
The Agency for Healthcare Research and Quality (AHRQ) seeks innovative proposals for scholarly research that advances rigorous, evidence-driven strategies to enhance healthcare competition and expand patient choice, thereby lowering costs and improving health outcomes for the American people.
Overview
Complex, duplicative, and overly restrictive healthcare mandates and regulations reduce competition, increase administrative burdens, impose excessive costs, and limit patient choice. These requirements may reduce consumer satisfaction by constraining provider and payer operations without improving healthcare quality or outcomes. Thus, streamlining or removing outdated or counterproductive regulations is essential to fostering more competitive, innovative, patient centered healthcare marketplaces that allow consumers to choose products and services that best meet their preferences and needs.
This challenge will support scholarly research dedicated to lowering healthcare spending and improving health outcomes by studying ways to enhance competition, decrease ineffective regulation, and increase patient choice. AHRQ seeks effective and impactful policy ideas, grounded in market mechanisms rather than centralized mandates, that will benefit American patients, employers, healthcare providers, and taxpayers, and improve overall satisfaction with our healthcare system. In the first phase, participants will propose a set of priority topics, describe detailed plans for successfully accomplishing their research, outline how findings will be disseminated within participating entities, and take steps to execute their proposed plans. Phase 1 winners will be eligible to compete for Phase 2 prizes, which will be awarded to participants that have produced the most promising and impactful research plans and demonstrated meaningful progress toward implementing the awardee’s vision. Phase 2 prizes will reward execution of Phase 1 research activities and milestones established in Phase 1 research plans.
Challenge Structure
This challenge has two phases. Participants selected to receive a Phase 1 prize may participate in Phase 2.
Key Dates
Phase 1: Participant Research Proposals
Submission period begins: Wednesday, Sept. 30, 2026, 5 p.m. ET
Submission period ends: Monday, Oct. 26, 2026, 5 p.m. ET
Phase 2: AHRQ Awards
Submission period begins: Tuesday, Dec. 15, 2026, 5 p.m. ET
Submission period ends: Tuesday, Feb. 2, 2027, 5 p.m. ET
Other Dates:
Phase 1 prize winners will be announced Tuesday, Dec. 1, 2026
Phase 2 prize winners will be announced Friday, March 5, 2027
Prizes
Total Cash Prizes
$11,800,000
Cash Prize Breakdown
AHRQ has indicated its intent to also award up to $11.8 million to the challenge winners from its own funds.
Specifically, for Phase 1, AHRQ has indicated its intent to select up to five submissions to receive no more than $3 million in total from the $11.8 million cash prize pool.
For Phase 2, AHRQ has indicated its intent to select up to five submissions to receive no more than $8.8 million in total from the $11.8 million cash prize pool.
If AHRQ fails to pay any portion of the monetary prize it has indicated it intends to provide, the Department of Health and Human Services (HHS) will not assume responsibility for the unpaid amount and will not issue payment on AHRQ’s behalf. For more information, please contact AHRQ.
Use of Cash Prizes
Cash prizes (not grants or contracts) may be awarded under this challenge announcement. HHS does not limit how winners may use prize money awarded to them. Therefore, winners may use prize money from one phase of this challenge toward submissions for future phases, but they are not required to do so.
Detailed Description
The United States spent $5.3 trillion on healthcare in 2024, a 7.35% increase from the previous year. Evidence suggests that much of this spending is wasteful and inefficient without positively impacting patient outcomes (https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical; https://jamanetwork.com/journals/jama/article-abstract/2752664; https://www.nejm.org/doi/full/10.1056/NEJMsa1212321;
https://paragoninstitute.org/public-health/what-matters-for-health-insurance-is-less-important-than-you-think/). The U.S. healthcare system is characterized by complex regulations affecting healthcare providers and insurers that are costly but often do not produce improvements in care quality or outcomes. Further regulations and other governmental actions reduce competition among health services providers. For example, in 2024, nearly half of metropolitan areas were dominated by one or two healthcare systems. Certificate of need and federal laws discouraging physician-owned hospitals reduce the supply of hospitals. Similarly, the Medicare Merit-based Incentive Payment System (MIPS) imposes significant reporting burdens that favor large practices.
In 2018, the Departments of the Treasury, Health and Human Services, and Labor released the report “Reforming America’s Healthcare System Through Choice and Competition” that examined the issues of overregulation and lack of competition in healthcare and proposed areas for reform. However, these problems have worsened since the release of the report. Between 2021 and 2024, new regulations restricted consumers’ choice of insurance plans, constrained the drug supply, and increased administrative burdens on healthcare providers. In addition, although well-intentioned in response to a bona fide need, the No Surprises Act increased administrative costs and placed upward pressure on healthcare prices.
In response, and consistent with its mandate to conduct research on healthcare costs, organization, and access, AHRQ seeks to fund participants to undertake innovative, evidence-driven investigation into ways to enhance competition in healthcare markets and increase patient choice, which will increase overall satisfaction. Challenge applicants are expected to identify policies and domains where regulation, limited competition, or constrained patient choice drive up costs or worsen patient outcomes, and develop actionable solutions that advance a more competitive, patient-centered healthcare system.
Successful Phase 1 submissions will have the following characteristics. First, they must propose and rely on rigorous evidence-based research that utilizes gold-standard science to inform specific and actionable policies, such as statutory, regulatory, or other changes. Second, proposed policy solutions must have large potential economic impacts and lead to improved outcomes for the American people. Third, research personnel engaged in the research activities should have demonstrated experience in policy and economic analysis as appropriate. Successful Phase 2 submissions will have rigorous plans for successfully accomplishing the proposals set forth in Phase 1 and a high likelihood of success based on Phase 1 results.
To support this work, AHRQ may make shared data and super intelligence (SI) capabilities available to Phase 2 participants, including common datasets, application programming interfaces (APIs), reusable analytic tools, and technical support. Participants may, consistent with applicable law and data-use restrictions, make resulting data products, code, models, and documentation publicly available or otherwise reusable. AHRQ may use findings derived from this challenge and collaborate with participants to create programs or generate and/or analyze data that will improve healthcare quality and outcomes for the American people.
Legal Authority
This challenge is authorized by the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education, and Science (COMPETES) Reauthorization Act of 2010, as amended (15 U.S.C. § 3719). AHRQ, a component of the U.S. Department of Health and Human Services, is dedicated to health services research. As set forth in 42 U.S.C. § 299, AHRQ’s mission is to enhance the quality, appropriateness, and effectiveness of health services and access to such services, through scientific research and the promotion of improvements in clinical and health system practices, including the prevention of diseases and other health conditions. AHRQ conducts research directed toward improving health outcomes and examining the quality, safety, and affordability of healthcare delivery. Consistent with AHRQ’s statutory mandates, this challenge seeks to generate innovative policies that will improve healthcare quality, outcomes, affordability, access, and value through investigation into healthcare organization, delivery, and financing.
Rules
Eligibility Rules
- To be eligible to win a prize under this challenge, a participant (whether an individual, team, or entity):
- Shall have registered to participate in the challenge as an individual, team, or entity under the rules and instructions promulgated by HHS as published in this announcement, including but not limited to, the “Prize Payment Rules” and the “How to Enter” section of this announcement;
- Shall have complied with all the requirements set forth in this announcement;
- In the case of a private entity, shall be incorporated in and maintain a primary place of business in the United States, and in the case of an individual or team participant, shall be a citizen or permanent resident of the United States;
- Shall not be a federal entity or federal employee acting within the scope of their employment;
- Shall not be an employee of the Department of Health and Human Services (HHS) or any other component of HHS, acting in their personal capacity;
- Who is employed by a federal agency or entity other than HHS (or any component of HHS), shall consult with an agency ethics official to determine whether the federal ethics rules will limit or prohibit the acceptance of a prize under this challenge;
- Shall not be a judge of the challenge, or any other party involved with the design, production, execution, or distribution of the challenge or the immediate family of such a party (i.e., spouse, parent, stepparent, child, or stepchild);
- Shall be 18 years of age or older at the time of submission.
- A participant (whether an individual, team, or entity) shall not be deemed ineligible because the participant used federal facilities or consulted with federal employees during the challenge if the facilities and employees are made available to all participants participating in the challenge on an equitable basis.
Participation Rules
- Participants (whether individuals, teams, or entities) may not use federal funds from a grant award or cooperative agreement to develop their challenge submissions or to fund efforts in support of their challenge submissions.
- Federal contractors may not use federal funds from a contract to develop challenge submissions or to fund efforts in support of challenge submissions. Costs associated with such activities are unallowable and are not allocable to government contracts.
- By participating in this challenge, each participant (whether an individual, team, or entity) agrees to assume any and all risks and waive claims against the federal government and its related entities, except in the case of willful misconduct, for any injury, death, damage, or loss of property, revenue, or profits, whether direct, indirect, or consequential, arising from participation in this challenge, whether the injury, death, damage, or loss arises through negligence or otherwise.
- Based on the subject matter of the challenge, the type of activities that it may involve, as well as an analysis of the likelihood of any claims for death, bodily injury, property damage, or loss potentially resulting from challenge participation, no participant (whether an individual, team, or entity) participating in the challenge is required to obtain liability insurance, or demonstrate financial responsibility, or agree to indemnify the federal government against third-party claims for damages arising from or related to challenge activities in order to participate in this challenge.
- By participating in this challenge, each participant (whether an individual, team, or entity) warrants that the participant is the sole author or owner of, or has the right to use, any copyrightable works that the submission comprises, that each such work is wholly original with the participant (or is an improved version of an existing work that the participant has sufficient rights to use and improve), and that the submission does not infringe any copyright or any other rights of any third party of which the participant is aware.
- By participating in this challenge, each participant (whether an individual, team, or entity) grants to HHS an irrevocable, paid-up, royalty-free, nonexclusive worldwide license to reproduce, publish, post, link to, share, and display publicly the submission on the web or elsewhere, and a nonexclusive, nontransferable, irrevocable, paid-up license to practice, or have practiced for or on its behalf, the solution throughout the world. Each participant will retain all other intellectual property rights in their submissions, as applicable. By participating in this challenge, each participant warrants that there are no legal obstacles to providing the above-referenced nonexclusive licenses of the participant’s rights to the federal government. To receive an award, participants will not be required to transfer their intellectual property rights to HHS, but participants must grant to the federal government the nonexclusive licenses recited herein. By participating in this challenge, participants are not granted any licenses to use or rights in any HHS trademarks, including the HHS logo. Participants may not imply endorsement by HHS or the federal government. Any use of HHS trademarks by participants is subject to prior written authorization by HHS and subject to any requirements of the HHS Office of the Assistant Secretary for Public Affairs (ASPA).
- Each participant (whether an individual, team, or entity) agrees to follow all applicable federal, state, and local laws, regulations, and policies.
- Each participant (whether an individual, team, or entity) participating in this challenge must comply with all rules and requirements included in this announcement, and participation in this challenge constitutes each participant’s full and unconditional agreement to abide by the rules and requirements. Winning is contingent upon fulfilling all requirements herein.
- As a condition for receiving a cash prize in this challenge, each participant (whether an individual, team, or entity) that has been selected as a winner must complete and submit all required winner verification and payment documents to HHS. Failure to return all required verification and payment documents by the date specified in the formal winner notification may be a basis for disqualification of a cash prize winning submission.
- By participating in this challenge, each participant (whether an individual, team, or entity) agrees that HHS may disqualify the participant’s submission if, in HHS’ judgment, the submission is inconsistent with HHS’ public health mission, may be ineffective or harmful, or if disqualification is otherwise deemed necessary.
Prize Payment Rules
- For each eligible participant under the “Eligibility Rules,” HHS will use that participant’s registration as an individual, team, or entity on the “HHS Challenge Participant Registration Form” to determine who receives payment of any HHS prize money.
- For an eligible winning participant registered as an individual, HHS will pay any prize money for the individual to the individual.
- For a winning participant registered as a team with an eligible team leader, HHS will pay any and all prize money for that team to the team leader, and division of the prize money is at the discretion of the team leader. HHS will not arbitrate, intervene, advise on, or resolve any matters among team members.
- For an eligible winning participant registered as an entity, HHS will pay any prize money for the entity to the entity.
- Prizes awarded under this challenge by AHRQ will be paid by electronic funds transfer and may be subject to federal income taxes. AHRQ will comply with the Internal Revenue Service withholding and reporting requirements, where applicable.
- Entities participating in this challenge are encouraged, but not required, to request and obtain a free Unique Entity ID (UEI), if they have not already done so, via SAM.gov, as this may expedite prize payment. Additional information can be found at https://sam.gov/content/entity-registration.
- Prizes offered by AHRQ will be paid directly by AHRQ.
Other Rules
HHS reserves the right, in its sole discretion, to (a) cancel, suspend, or modify the challenge, or any part of it, for any reason, and/or (b) not award any prizes if no submissions are deemed worthy.
Judging
The HHS Award Approving Official will be Dr. Roger Klein MD/JD, Director of the Agency for Healthcare Research and Quality. AHRQ is responsible for any final decisions regarding prizes paid with its own funds.
Basis Upon Which a Winner Will Be Selected
All submissions will be prescreened for eligibility and compliance with the rules of the challenge, including the submission guidelines. Only complete submissions confirmed to meet all eligibility requirements will move forward for judging. Submissions deemed to be eligible will be presented to an evaluation panel composed of technical experts with subject-matter expertise relevant to the challenge goals and using the evaluation criteria below. The evaluation panel will individually assess each submission and provide their scores to the judging panel. The judging panel, composed of federal employees from AHRQ and potentially other agencies, will recommend the winners pending final award decision approval by the Award Approving Official.
Phase 1 Judging Criteria: Participant Proposals
Phase 1 submissions will be judged on the basis of the following criteria:
- Potential Impact. If successfully enacted, will the proposed policies or solutions have a substantial economic impact or substantially impact healthcare outcomes?
- Choice/Competition. To what extent do the proposed policies or solutions increase competition or promote patient choice and satisfaction in healthcare markets?
- Feasibility/Specificity. Are the proposed policies or solutions described in sufficient detail? How feasible are the proposed solutions or policies?
- Novelty. How novel are the proposed solutions or policies?
- Research Strength. How robust is the proposed research in support of the proposed policies or solutions?
- Participant Personnel. Does the proposed team have demonstrated expertise and experience to execute the proposed research?
- Data, SI, and Reusability. Does the proposed participant have a credible plan to obtain and integrate needed data, use SI or advanced analytics where appropriate, and produce reproducible, appropriately shareable data and analytic products?
Phase 2 Judging Criteria: Participant Impact
- Research Strength: To what extent did the participant produce rigorous research in support of the proposed policies/solutions outlined in Phase 1?
- Research Impact: To what extent did the participant have an impact? Impact can take various forms, including but not limited to publications, conference presentations, and policymaker engagement.
- Data and Reusable Infrastructure: To what extent did the participant produce and disseminate reusable data, code, APIs, models, or other analytic tools that enable subsequent research or policy analysis?
How to Enter
To enter this challenge, participants must:
- register by emailing one signed PDF of the “HHS Challenge Participant Registration Form” (see www.ahrq.gov/healthcarechoice/register.html) per submission to HealthcareChoice@ahrq.hhs.gov and
- email your challenge submission to HealthcareChoice@ahrq.hhs.gov.
Additional Information Regarding Registration
Registration is required to be eligible to win a cash prize. When you register using the “HHS Challenge Participant Registration Form,” you will need to decide whether you are registering as:
- an individual (on behalf of yourself);
- a team (on behalf of a group of people competing together, but not on behalf of an established organization, institution, or corporation). If registering as a team, each participating team is required to designate an eligible team leader who will register and submit on behalf of the team members. The team leader is responsible for all communications with HHS; or
- an entity (on behalf of a legally established organization, institution, or corporation).
Your decision to register as an individual, team, or entity on the “HHS Challenge Participant Registration Form” will determine who HHS pays any prize money from this challenge. Please see “Prize Payment Rules” in the “Rules” section. Before registering, you may wish to consider any potential tax consequences of registering as an individual, team, or entity.
The “HHS Challenge Participant Registration Form” is available under the “Resources” section for this challenge.
HHS reserves the right, in its sole discretion, to grant or deny any request to update registration information on the “HHS Challenge Participant Registration Form.”
Additional Information Regarding Submissions
Submission Requirements
Phase 1 and Phase 2 submissions should be limited to 15 single-spaced pages, with a font size no smaller than 11-point Arial and with margins no smaller than 1 inch.
While there is no specific required format, Phase 1 submissions should include a discussion of:
- The policies the participant will examine. As part of this, participants should address the judging criteria, such as the economic significance of the policies they are proposing as well as the extent to which the proposed policies increase competition or patient choice and satisfaction in healthcare markets.
- The research the participant will pursue in support of these policies. Participants should ensure that the proposed research is rigorous and in line with the principles outlined in the HHS Gold Standard Science Report.
- A description of participant personnel, including how the experience and expertise of the participant personnel place them in a position to compete successfully for Phase 2.
Similarly, there is no specific required format for Phase 2 submissions, but they should include a discussion of:
- The research that was actually carried out in support of the policies proposed in Phase 1, such as research methods, results, and conclusions.
- Actions the participant team took to increase the impact of their research, such as publications or policymaker engagement.
Resources
- HHS Challenge Participant Registration Form: www.ahrq.gov/healthcarechoice/register.html
- Point of Contact/Questions: Jay Toven, Executive Officer, HealthcareChoice@ahrq.hhs.gov
Frequently Asked Questions
What is the purpose of this challenge? The challenge supports rigorous, evidence-driven research on policies and strategies that can increase healthcare competition and patient choice, lower healthcare spending, and improve health outcomes.
How is the challenge structured? The challenge has two phases. Phase 1 focuses on participant research proposals and initial progress. Participants selected for a Phase 1 prize may participate in Phase 2, which evaluates execution of the Phase 1 research activities and milestones.
What should a Phase 1 submission address? Phase 1 submissions should describe the policies the participant will examine, the rigorous research the participant will pursue in support of those policies, and the participant personnel and their relevant experience and expertise. Applicants should also address the Phase 1 judging criteria.
How will Phase 1 submissions be evaluated? Phase 1 submissions will be evaluated for potential impact, effects on choice and competition, feasibility and specificity, novelty, research strength, participant personnel, and plans for data, super intelligence, advanced analytics, and reusable analytic products.
What should a Phase 2 submission address? Phase 2 submissions should describe the research actually carried out in support of the policies proposed in Phase 1, including methods, results, and conclusions, as well as actions taken to increase the impact of the research, such as publications, conference presentations, or policymaker engagement.
How will Phase 2 submissions be evaluated? Phase 2 submissions will be evaluated on research strength and research impact, including, when appropriate, production and dissemination of reusable data, code, application programming interfaces, models, or other analytic tools.
What are the submission length and formatting requirements? Phase 1 and Phase 2 submissions should be no more than 15 single-spaced pages, use Arial font no smaller than 11 points, and have margins no smaller than 1 inch.
Is registration required? Yes. Registration is required to be eligible to win a cash prize. Participants register as an individual, team, or entity using the HHS Challenge Participant Registration Form. A team must designate an eligible team leader who registers and submits on behalf of the team.
Does the registration category affect prize payment? Yes. HHS uses the participant’s registration category to determine who receives any prize payment. An individual is paid directly, a team prize is paid to the team leader, and an entity prize is paid to the entity.
May federal funds be used to develop a challenge submission? No. Participants may not use federal funds from a grant award or cooperative agreement to develop a submission or support challenge submission efforts. Federal contractors also may not use federal contract funds for these activities.
May prize money from one phase be used for a later phase? Yes. Winners may use prize money from one phase toward submissions for future phases, but they are not required to do so.
What happens to intellectual property submitted to the challenge? Participants retain their applicable intellectual property rights. Participation requires granting HHS the nonexclusive licenses described in the Participation Rules. Winning does not require transfer of intellectual property rights to HHS.
Will AHRQ provide data or super intelligence resources? AHRQ may make shared data and super intelligence capabilities available to Phase 2 participants, including common datasets, application programming interfaces, reusable analytic tools, and technical support, subject to applicable law and data-use restrictions.
Is a Unique Entity ID required for an entity to participate? No. Entities are encouraged, but not required, to obtain a free Unique Entity ID through SAM.gov because doing so may expedite prize payment.
