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

Slide presentation from the AHRQ 2011 conference.

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.

Slide 4


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

Care SiteNumber
Other Specialty3
Primary Care13

Slide 5

ARRA Delivery System FOA Grantees: Primary Health Conditions

Health ConditionNumber
Cardiological conditions + hypertension2
Mental Health + substance abuse4
Multiple Chronic Conditions6
Pediatric Health1
Chronic Kidney Disease1

Slide 6

ARRA Delivery System FOA Grantees: Geographic Spread

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

Slide 7

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.

Slide 8

For more information

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.
Page last reviewed October 2014
Internet Citation: Delivery System Research: Discovering Ways to Improve Care Value (Text Version). October 2014. Agency for Healthcare Research and Quality, Rockville, MD.


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