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Questions and Answers

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Transforming Primary Care Funding Opportunity Announcement (FOA) HS-10-002

Who is eligible to apply?

  • Please consult the FOA. Eligible institutions include:
    • Public institutions, e.g., department of public health
    • Nonprofits, e.g., Federally Qualified Health Centers
  • For-profits are not eligible to be applicant institutions. Personnel from for-profit organizations may participate in a grant application submitted by an eligible institution.

Is this a one-time only FOA?

  • Yes, proposals must be submitted by the November 18 deadline.
  • However, AHRQ will be releasing other FOAs on related topics. Stay tuned.

Are pediatric practices welcome?

  • Absolutely. Pediatric practices are primary care practices.

Can we restrict the study to a particular subset of the population we serve (e.g., a certain age group, individuals with particular chronic conditions)?

  • The study may restrict outcome measures to subsets of the population served. However, the transformation being studied should be at the delivery system level.
  • For example, a study of the impact of a diabetes quality improvement project would not be responsive to the FOA. However, a study of a transformation of primary care to be a patient-centered medical home that used diabetes quality measures, among other measures, would be responsive.

How many practices need to be included in the study?

  • The FOA is intentionally silent on the question of a minimum number of practices.
  • Applicants should bear in mind that the chief objective of this FOA is to learn about the transformation process and disseminate that knowledge. What you need to think about is whether the experiences of your practices would provide important lessons of national interest on how to transform a practice to a medical home.

Does the transformation have to have already taken place?

  • Yes, the transformation has to be already implemented, preferably for at least a year.
  • There must be some evidence that the transformation has been successful.
  • It would not be responsive to propose to initiate practice transformation strategies and study their impact.
  • We recognize that transformation is a dynamic process and that transformations will continue during the course of the study. Study methods should take this into account.

Can we study new practices that use the model of a patient-centered medical home?

  • No. We are seeking to learn how to go from the current system of delivering primary care to a patient-centered medical home. The practice therefore has to go from one state to another, i.e., it must not be a patient-centered medical home at one point in time, and then transform into one.

Would it be responsive to study the impact of a new electronic health record (EHR) or care manager program?

  • No. While an EHR or care manager might be an element in a practice transformation, by itself it does not constitute transformation to a patient-centered medical home.
  • This FOA is not appropriate for studying the impact of distinct quality improvement projects.

May resources be used to help practices who are being studied?

  • The application may include funding for study sites to compensate them for data collection activities.
  • Because the transformation strategies will have already been implemented, AHRQ does not anticipate that grant funds will be used to deliver technical assistance.
  • Because transformation is an ongoing process, AHRQ has no objection to formative evaluation designs, whereby the results are shared with the practices in real time.

How much and what type of evidence of the success of transformation strategies is needed?

  • We recognize that these transformations will not have been fully evaluated, or you would not be responding to this FOA.
  • There is no prescribed strength of evidence. Applicants will want to present a compelling case that the proposed transformation has achieved significant progress toward establishing a patient-centered medical home that is worth replicating.

To what extent should we focus on analyzing existing data versus collecting and analyzing new data during the term of the grant?

  • Both analyses of existing but unanalyzed data and collection and analysis of new data are appropriate activities for applications.

Do we have to demonstrate changes in both clinical and operational processes and in clinical and operational outcomes (e.g., practice costs)?

  • The FOA calls for studying both process and outcome measures, and studying both clinical and cost impact.
  • Applications that omit measures in any of these domains will be scored lower than applications that address all the domains listed in “Objective #2: Research and Analysis Plan” of the FOA.”

Current as of October 2009

 

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