Delivery System Research: Discovering Ways to Improve Care Value (Text Version)
Delivery System Research: Discovering Ways to Improve Care Value*
Michael I. Harrison
Center for Delivery, Organization & Markets
AHRQ Annual Meeting
Sept. 20, 2011
- AHRQ's ARRA [American Recovery and Reinvestment Act] Delivery System Research Initiative.
- Recommendations on Advancing Delivery System Research.
- Progress Reports/Early Findings.
Delivery System Funding Opportunity Announcements (FOAs)
- 6 Evaluation Grants ($12 million)—Request for Applications (RFA) 10-012:
- Research on existing designs or redesigns (interventions) in payment, reporting, and organization of care delivery.
- CER= compare alternative designs or redesigns; compare one redesign to status quo accepted as current policy.
- 4 Demonstration Grants ($7 million)—RFA 10-013—Implementation & Research on effectiveness of redesigns in:
- Primary care.
- Care continuum.
- Payment and reporting.
- 5 Spread Demonstration Grants ($18 million)—Accelerating Implementation of CER Findings through Networks—RFA 10-014:
- Spread of CER findings by leveraging the capacities of multi-stakeholder or multi-site networks: Goal is implementation of existing evidence, not creation of new evidence.
- Evaluation to be conducted by external contractor.
ARRA Delivery System FOA Grantees: Impacted Sites of Care
(1-2 sites per study)
ARRA Delivery System FOA Grantees: Primary Health Conditions
|Cardiological conditions + hypertension||2|
|Mental Health + substance abuse||4|
|Multiple Chronic Conditions||6|
|Chronic Kidney Disease||1|
ARRA Delivery System FOA Grantees: Geographic Spread
Image: A map of the United States with grantee states highlighted is shown.
Meeting: Advancing Delivery System Research
- ARRA CER Delivery System grantees, other grantees, stakeholders, experts discuss white papers:
- Gaps in Research Topics & Concepts.
- Research Designs, Methods, & Measures.
- Spread Strategies.
- Steps for Researchers—Most need leadership by funders:
- Use more mixed methods (Needed: journal, study section support).
- Examine diverse contexts for improvements.
- Model change over longer time periods (3+ yrs).
- Apply common evaluation frameworks for similar initiatives (e.g., Pay for Performance [P4P], Patient Centered Medical Home [PCMH]).
- Test valuable improvements in additional, diverse contexts.
- Develop measures for readiness, change contexts, culture.
For more information
- Michael Harrison (RFA 10-012, 10-013 and meeting)
- Dina Moss (RFA 10-014)
Reports from Delivery System Research Teams
- Michael Magill, MD, University of Utah School of Medicine.
- Rebecca A. Malouin, PhD, Michigan State University.
- Wally R. Smith, MD, Virginia Commonwealth University.