(from left): Tiffany Robins, Bay Aging Director of Health Services; Cathey Eades, VAAACares® Director; Kathy Vesley, Bay Aging President & CEO; and Julie Northcott-Wilson, Bay Aging Director of Strategic Analysis, will help lead the initiative as VAAACares® advances in ACL’s national Health at Home Challenge.

Bay Aging announced that VAAACares®, Virginia’s Community Care Hub and a Bay Aging-led statewide collaborative, has been selected as one of twelve Phase 1 winners in the U.S. Department of Health and Human Services’ Administration for Community Living (ACL) Health at Home Challenge. The national competition is designed to help dually eligible and near-dually eligible Medicare and Medicaid beneficiaries with chronic conditions and functional limitations remain safely at home by expanding advanced community care networks.

VAAACares®’ winning proposal reflects Bay Aging’s leadership in building community-clinical partnerships that connect health plans, health systems, accountable care organizations, and trusted community-based organizations. Acting as an Advanced Community Care Hub, VAAACares® will work to scale person-centered services that support independence, address health-related social needs, and help reduce avoidable health care costs.

The proposal sets an ambitious goal: to induct 100,000 clients over the next three years through coordinated services that help people live in their homes and communities, where they prefer to be. Those services may include care coordination, transitional care support, nutritious meals, transportation, housing-related assistance, chronic disease self-management, caregiver support, and other community-based interventions tailored to each person’s needs.

“This recognition affirms the power of bringing health care and community-based services together around the needs and goals of each person,” said Kathy Vesley, President & CEO of Bay Aging. “Through VAAACares®, Bay Aging and our partners are demonstrating how an Advanced Community Care Hub can make it easier for health care organizations to connect people with the everyday supports that keep them safe, independent, and healthier at home.”

ACL launched the Health at Home Challenge to scale advanced community care networks led by Community Care Hubs that integrate health care and community care for high-need populations. The Challenge emphasizes that many factors influencing health occur outside clinical settings, including access to food, safe housing, transportation, fall prevention, chronic disease support, care transitions, and long-term services and supports.

VAAACares® is a nationally recognized, NCQA-accredited Community Care Hub that provides a single point of contracting and coordination for health care partners seeking to address health-related social needs. By centralizing key administrative functions and aligning a statewide network of aging and disability service providers, VAAACares® helps local organizations scale services efficiently while preserving the trusted community relationships that are essential to effective care.

The Health at Home Challenge will unfold over multiple phases, with later phases focused on implementation, scaling, increasing days at home, and reducing total cost of care. VAAACares® will continue working with partners across Virginia to strengthen community-clinical integration and expand access to whole-person services for older adults and people with disabilities.