Delivery System Research: Discovering Ways to Improve Care Value (Text Version)

On September 20, 2011, Michael Harrison made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (335 KB). Plugin Software Help.

Slide 1

Delivery System Research: Discovering Ways to Improve Care Value*

Michael I. Harrison
Center for Delivery, Organization & Markets
AHRQ Annual Meeting
Sept. 20, 2011

*Thanks to Dina Moss, co-lead on this initiative.

Slide 2

Session Overview

• AHRQ's ARRA [American Recovery and Reinvestment Act] Delivery System Research Initiative.
• Recommendations on Advancing Delivery System Research.
• Progress Reports/Early Findings.
• Discussion.

Slide 3

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.

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ARRA Delivery System FOA Grantees: Impacted Sites of Care
(1-2 sites per study)

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ARRA Delivery System FOA Grantees: Primary Health Conditions

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ARRA Delivery System FOA Grantees: Geographic Spread

Image: A map of the United States with grantee states highlighted is shown.

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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.

http://www.ahrq.gov/qual/deliverysys/2011mtg/mtgsumm.htm.

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For more information

• http://www.ahrq.gov/qual/deliverysys/2011mtg/mtgsumm.htm.
• Michael Harrison (RFA 10-012, 10-013 and meeting)
  Michael.Harrison@ahrq.hhs.gov.
• Dina Moss (RFA 10-014)
  Dina.Moss@AHRQ.hhs.gov.

Slide 9

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.