A Stronger Start for Kids: Understanding the ASPIRE Model

For millions of children across the country, Medicaid and the Children’s Health Insurance Program (CHIP) are a lifeline.

Together, these programs cover approximately half of all children with complex medical and behavioral health needs or those at risk of developing them. Yet for too many families, the care their children receive is fragmented, difficult to navigate, and adds pressure to their daily lives.

The Centers for Medicare & Medicaid Services Innovation Center recently announced a new approach designed to change that trajectory: the ASPIRE Model, short for Accelerating State Pediatric Innovation Readiness and Effectiveness.

ASPIRE represents an important shift in how states can support children and families — one that aligns with what children’s hospitals already know: Kids do best when care is coordinated, preventive, and centered on the whole child.

Why ASPIRE matters

Children with complex medical and behavioral health needs often require services from multiple providers across physical health, behavioral health, and community-based systems. Too often, those systems operate in silos. When care is uncoordinated, families are left to manage appointments, information, and follow‑up on their own.

CMS designed the ASPIRE Model to support whole person care for children and youth up to age 21 who are enrolled in Medicaid or CHIP and who have, or are at risk of developing, complex medical or behavioral health needs.

What the ASPIRE Model does

ASPIRE is a state-based, voluntary model that will run for 10 years, with up to five states eligible to participate. CMS plans to release a Notice of Funding Opportunity in the summer of 2026.

At its core, the model aims to:

• Support care coordination across physical health, behavioral health, and community supports
• Encourage early identification and intervention to address needs before they escalate
• Position Medicaid providers to focus on quality and cost of care
• Incorporate quality measures focused on outcomes, particularly for children with complex needs

By shifting away from fragmented, fee‑for‑service approaches, ASPIRE is designed to help children receive the right care, at the right time, in the least restrictive settings possible.

A whole‑child approach with long‑term impact

Improving care early in life can help children thrive over the long term, reducing the need for more intensive services later and improving quality of life for children, youth, and their families.

This focus on prevention, coordination, and outcomes reflects a growing recognition that children’s health is shaped not just by clinical care, but by how well systems work together to support families at home, in school, and in communities.

What this means for children’s hospitals

Children’s hospitals play a critical role in caring for children with complex medical and behavioral health needs. ASPIRE creates a new opportunity for states to build on that expertise by strengthening care models that reflect the unique needs of children and the providers who serve them.

CHA connected the CMS Innovation Center with experts at children’s hospitals to inform this new model and will continue to partner on this model as CMS develops more details. We will monitor developments closely and share updates on what ASPIRE could mean for children’s hospitals, pediatric providers, and the families they serve.

When systems are designed around children — not fragmented processes — kids have a better chance to grow, thrive, and reach their full potential.

We appreciate the CMS Innovation Center’s focus on kids and its recognition that children with complex needs require coordinated, whole-person care. As ASPIRE moves forward, we look forward to continued collaboration to ensure this model best supports children, families, and the providers who care for them.