Market concentration has reached a tipping point, as recent data shows a lack of competition across much of the United States. A March 2026 KFF analysis revealed that one or two health systems currently dominate inpatient care in nearly half of all metropolitan areas. In 83% of these regions, a duopoly controls more than 75% of the market, effectively insulating providers from the pressure to lower costs or improve service quality.

AHRQ Director Roger D. Klein stated that the initiative aims to solicit practical, evidence-based strategies from researchers, academic institutions, and private teams to dismantle these barriers. The project is split into two funding rounds: $3 million earmarked for the initial phase and $8.8 million for the follow-up. Applications for the first stage must be submitted by October 26, 2026, with judges evaluating proposals based on their novelty, feasibility, and potential impact on the national healthcare landscape.