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ARRA OS Recovery Act Limited Competition:
Comparative Effectiveness Delivery System Demonstration Grants (R18)

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Questions and Answers

The following set of questions and answers features responses from the Agency for Healthcare Research and Quality (AHRQ) to questions from the public submitted about the Agency's funding opportunity announcement for RFA-HS-10-013: Recovery Act 2009 Limited Competition: Comparative Effectiveness Delivery System Demonstration Grants (R18).

Question #1: Will the submission date be extended?
Answer #1: If extensions are made for grant solicitations, it will be posted in the NIH Guide and on the AHRQ Web site. It will also appear in the solicitation.

Question #2: Will there be additional funding opportunities under the OS-ARRA funding for 2010?
Answer #2: All the OS-ARRA funding opportunities for 2010 have been announced; these solicitations will not be re-issued.

Question #3: Can respondents submit an application that was reviewed elsewhere but not funded?
Answer #3: Yes. However, applicants should not use the procedure for submitting a revised application. Instead, applicants should make appropriate changes in the title and contents to align with the RFA and to respond to feedback from prior reviewers and submit the application as a new application.

Question #4: Why does this RFA and other ARRA-supported RFAs bear the heading of "limited competition"?
Answer #4: The term "limited competition" conveys the fact that these solicitations will not be re-issued and that no revisions are permitted. Awards for all ARRA-OS RFAs must be made no later than September 30, 2010.

Question #5: Will applications be reviewed separately according to topic?
Answer #5: No. All applications to this RFA will be reviewed in a single peer-review session. However, when making funding decisions about applications that were highly scored by the study section, AHRQ may take into account the topics and themes of the proposed demonstrations — in addition to their scientific merit and potential significance for policy and practice.

Question #6: How should applicants decide whether to apply to this RFA or to RFA 10-012?
Answer #6: These two RFAs form a pair. RFA 10-013 (R18) invites applications to conduct and assess demonstrations of (1) broad strategies and/or specific interventions for improving care by redesigning care delivery, or (2) strategies and interventions for improving care by redesigning payment. The demonstrations will aim to achieve major improvements in care quality (including clinical outcomes and other dimensions), improve access to care, reduce disparities, or improve population-based measures of health outcomes. This RFA calls for demonstration design, implementation, research on the implementation process, and research on results. In contrast, RFA 10-012 (R01) calls only for research evaluations of designs and improvements that are already in place.

Question #7: Do the standard AHRQ rules for young investigators apply?
Answer #7: AHRQ does not use the "new investigator" designation (as NIH does). Incorporating senior people into the team or having a senior PI are worth considering as ways of strengthening the application

Question #8: We will not be utilizing a payor plan with Medicaid and Medicare. Does this exclude us from applying for this grant?
Answer #8: No.

Question #9: Is a VA clinic population suitable for this RFA?
Answer #9: Yes. In your application, as in any, be sure to address issues of the generalizability of your study.

Question #10: Are VA researchers eligible?
Answer #10: Yes. Be sure to review the HHS Grants Policy Statement for "Grants to Federal Institutions and Allowable Costs and Payments to (or on Behalf of) Federal Employees under Grants" at for allowable and unallowable costs. (Microsoft® Word® files can be viewed with the free Word® Viewer. Exit Disclaimer).

Question #11: What is included in "total costs"?
Answer #11: All direct costs and all indirect costs are included in total costs.

Question #12: What are the page limits and format requirements?
Answer #12: The page limit for this RFA is 30 pages.

Specific instructions provided in this RFA supersede general guidance provided in the SF424 form. For questions about AHRQ format requirements, see the AHRQ Notice on AHRQ Implementation of Enhanced Peer Review (available at

Another useful site explains the details of new SF424 application form components (and also includes comparisons to the old format). The "Details of Application Changes for Research Grants and Cooperative Agreements" (for due dates on or after January 25, 2010) can be found at (PDF File, 106 KB; PDF Help)

Question #13: Would AHRQ be interested in building on an activity that was begun by a private foundation?
Answer #13: Prior funding by another agency does not pose a barrier and may be considered a sign of merit.

Question #14: Where can applicants find a list of AHRQ-identified evidence gaps?
Answer #14: AHRQ-identified evidence gaps refers to research and literature reviews published by or supported by AHRQ that point to areas where more evidence is needed. AHRQ's Evidence-based Practice reports (available at would be examples, but are by no means the only source that identifies such gaps.

Question #15: Would a three-hospital trial be of sufficient size?
Answer #15: There are two issues here. The first is whether the three-hospital trial is sufficient to provide methodological rigor. This depends in part on how the study is designed, but it may be an issue. The second consideration is whether the study will produce results that are likely to have implications for many diverse hospitals across the country. A larger trial with more internal diversity is more likely to meet that criterion. The reviewers are likely to consider both aspects of trial size, along with the other issues listed in the review criteria in the RFA.

Question #16: We are interested in a demonstration of the effects of introducing an health IT innovation to improve the quality and value of health care delivery in a specific hospital department. We have discovered that we would have to change patient flow before patients can fully use the innovation. Does this fit the scope of the RFA?
Answer #16: If you are designing a change in patient flow and the IT supports that change, then the concept fits within this RFA, in which the emphasis is on design and implementation, as well as the evaluation. If the focus of the study is simply on evaluating the IT innovation, it would not fit the RFA. As the RFA states: "Demonstrations may introduce new health information technology (IT) applications or build on existing applications, but the focus of the demonstration should be on the redesign of care delivery, rather than on the introduction and testing of a particular health IT application or IT system."

Question #17: We plan a comparison of an inpatient health care system redesign with a more traditional readmission intervention focused primarily on the outpatient, immediate post-discharge period. Does this fit the scope of the RFA?
Answer #17: Yes.

Question #18: We are interested in a study of the governance characteristics of hospitals, and outcomes of care. Does this fit the scope of the RFA?
Answer #18: This is not a demonstration. The concept might be more appropriate for RFA 10-012.

Question #19: We are interested in assessing the cost-effectiveness of a supplementary non-clinical patient service in the context of inpatient care. Does this concept align with the RFA?
Answer #19: No. You are not proposing a demonstration project.

Question #20: Are there other relevant FAQs?
Answer #20: Yes. Some of the FAQs for RFA-10-012: ARRA OS Recovery Act 2009 Limited Competition: Comparative Effectiveness Delivery System Evaluation Grants (R01) (available at are also relevant to RFA-10-013.

Current as of March 8, 2010


The information on this page is archived and provided for reference purposes only.


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