The U.S. Department of Health and Human Services (HHS) announced on May 8 the first 26 awards under a $1 billion competitive grant program administered by the Center for Medicare and Medicaid Innovation (CMMI) under section 3021 of the Affordable Care Act (ACA). The first 26 awards are for $122.6 million over 3 years and are estimated to achieve savings of $254 million within the same periods. The top awards were to the University Hospitals of Cleveland ($12.7 million), the Emory University Center for Critical Care ($10.7 million), the Pittsburgh Regional Health Initiative ($10.4 million), and Duke University ($9.7 million). The Duke University project seeks to help 57,000 persons with diabetes in four counties in North Carolina, Mississippi, and West Virginia, using informatics systems to stratify patients and neighborhoods by risk, target communities in need of interventions, and develop appropriate decision support and real-time monitoring systems. The Emory University project will deploy 40 critical care professionals to offer training and support in the use of tele-ICU services for critically ill persons in rural and underserved areas in northern Georgia in order to improve access to specialized care and reduce medical transportation costs. The next recipients in this on-going series of innovation awards will be announced in June 2012.