Opportunity Information: Apply for RFA HS 10 021
Apply for RFA HS 10 021
- The Agency for Health Care Research and Quality in the health sector is offering a public funding opportunity titled "Medical Liability Reform and Patient Safety Demonstration Projects (R18)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.226 Research on Healthcare Costs, Quality and Outcomes.
- This funding opportunity was created on Oct 20, 2009 and posted on Oct 20, 2009.
- Applicants must submit their applications by Jan 20, 2010. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $21,000,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $3,000,000.00 in funding.
- Eligible applicants include: State governments.
- Other Eligible Applicants include the following Established health care systems. Hsiao defines a health system as having capacities (e.g., hospitals, physicians), activities (e.g., health services), interconnections (e.g., financing, oversight, management), and purpose.30 Its components might include multiple States, localities, Tribal governments, universities, colleges, hospitals, nonprofit organizations, faith based organization, community based organizations, and Federal agencies. Applicants to this FOA must share a long established, legal entity as sponsor, and sufficient service volume to statistically power any proposed intervention. Organizations must also fit under AHRQs grant authorization under 42 USC 299c 5(c), which allows AHRQ to make grants to public and nonprofit entities. Other organizations may participate in projects only as subcontractors. Because the purpose of this program seeks to improve healthcare in the United States, foreign institutions may participate in projects only as subcontractors. Organizations described in section 501(c) 4 of the Internal Revenue Code that engage in lobbying may not participate.
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Opportunity Summary:
The Medical Liability Reform and Patient Safety Demonstration Projects (R18) funding opportunity (RFA HS 10 021) is a discretionary grant program run by the Agency for Health Care Research and Quality (AHRQ) to support real-world demonstration projects that test new approaches to medical liability while keeping patient safety at the center. The core idea is to help States and large, established health care systems develop, implement, and evaluate liability models that reduce preventable patient injuries, encourage clearer and more productive communication between clinicians and patients, and ensure that patients who are harmed receive compensation that is fair and delivered more quickly. At the same time, the program aims to reduce the frequency of frivolous lawsuits and, ultimately, reduce pressure on malpractice liability premiums by improving how injuries are prevented, disclosed, and resolved.
This FOA uses AHRQ's Large Research Demonstration and Dissemination Grant (R18) mechanism, which is designed for applied, practice-based projects that go beyond planning and move into implementation and evaluation, with an expectation that findings can be shared and used by others. Proposed projects can vary widely in design and scope, so AHRQ does not pre-set a fixed award size for every grantee, but it does impose strict upper limits on budget and timeline. Each award is capped at a total of $3,000,000 in total costs over a maximum project period of three years. Applicants are allowed to distribute funds across the three years in whatever pattern best matches their work plan, but applications exceeding either the three-year duration or the $3 million total cost ceiling are not reviewed. Continued funding after year one is not automatic; it depends on AHRQ's review of an annual progress report and a determination that progress is satisfactory.
Overall funding for the initiative was estimated at $21,000,000, with the number of awards dependent on available funds and the number of high-quality applications received. In other words, AHRQ planned to make multiple awards, but the final count and total dollars committed would be driven by merit, proposed duration, and requested budgets within the program limits.
Eligibility is targeted and emphasizes capacity to carry out statistically meaningful, system-level demonstrations. The primary eligible applicants are State governments, along with other eligible applicants described as established health care systems. In the FOA, a "health system" is framed broadly as an entity with the capacities (such as hospitals and clinicians), activities (delivery of health services), interconnections (financing, oversight, management), and a shared purpose needed to implement coordinated interventions. These systems may involve multiple partners and jurisdictions, potentially including States and localities, Tribal governments, universities and colleges, hospitals, nonprofit organizations, faith-based and community-based organizations, and Federal agencies. A key requirement is that applicants share a long-established legal entity as the sponsor and have sufficient service volume to provide the statistical power needed to evaluate the intervention credibly. Under AHRQ's authorizing statute (42 USC 299c-5(c)), awards can be made to public and nonprofit entities; other organizations can participate only as subcontractors. Foreign institutions are also limited to subcontractor roles, reflecting the program's focus on improving health care in the United States. In addition, organizations classified under section 501(c)(4) that engage in lobbying are not allowed to participate.
From an administrative standpoint, the FOA was posted on October 20, 2009, with an original and final application closing date of January 20, 2010, and an archive date of February 20, 2010. The CFDA listing associated with the program is 93.226 (Research on Healthcare Costs, Quality and Outcomes). There is no cost-sharing or matching requirement, meaning applicants are not required to contribute non-federal funds as a condition of receiving the grant.
In practical terms, this opportunity was built for large-scale, evidence-generating pilots that try to redesign how medical injuries are prevented and handled, linking patient safety improvements with better claims resolution processes. Successful projects under this model would be expected to show measurable effects on safety outcomes, communication practices, timeliness and fairness of compensation where appropriate, and downstream liability-related outcomes such as claim patterns or administrative costs, with results that can be disseminated to inform broader adoption.
Frequently Asked Questions (FAQs)
What is this funding opportunity?
The Medical Liability Reform and Patient Safety Demonstration Projects (R18) (RFA HS 10 021) is a discretionary grant program run by the Agency for Health Care Research and Quality (AHRQ). It funds real-world demonstration projects that test new medical liability approaches while keeping patient safety as the central focus.
What is the main purpose of the program?
The program supports projects that develop, implement, and evaluate medical liability models intended to reduce preventable patient injuries, improve communication between clinicians and patients, and ensure that harmed patients receive fair compensation more quickly. It also aims to reduce frivolous lawsuits and reduce pressure on malpractice liability premiums by improving how injuries are prevented, disclosed, and resolved.
What type of projects does AHRQ want to fund?
AHRQ is looking for applied, practice-based demonstration projects that go beyond planning and move into implementation and evaluation. Projects are expected to generate findings that can be shared and used by others.
What grant mechanism is used for this opportunity?
This opportunity uses AHRQ's Large Research Demonstration and Dissemination Grant (R18) mechanism, which is designed for implementation-focused demonstration projects and dissemination of results.
Is there a maximum funding amount per award?
Yes. Each award is capped at $3,000,000 in total costs.
What is the maximum project period?
The maximum project period is three years.
Can the budget be spread unevenly across the three years?
Yes. Applicants may distribute funds across the three years in whatever pattern best matches their work plan, as long as the total costs do not exceed $3,000,000 and the project does not exceed three years.
What happens if an application exceeds the budget cap or the maximum project period?
Applications that exceed either the three-year duration or the $3,000,000 total cost ceiling are not reviewed.
Is continued funding after the first year guaranteed?
No. Continued funding after year one is not automatic. It depends on AHRQ's review of an annual progress report and a determination that progress is satisfactory.
How much total funding was planned for the initiative?
Overall funding for the initiative was estimated at $21,000,000.
How many awards did AHRQ plan to make?
AHRQ planned to make multiple awards, but the final number depends on available funds and the number of high-quality applications received. Award count and total dollars committed were expected to be driven by merit, proposed duration, and requested budgets within program limits.
Who is eligible to apply as a primary applicant?
Eligibility is targeted. The primary eligible applicants are State governments and other eligible applicants described as established health care systems.
How does the FOA define a "health system"?
The FOA frames a health system broadly as an entity with the capacities (such as hospitals and clinicians), activities (delivery of health services), interconnections (financing, oversight, management), and a shared purpose needed to implement coordinated interventions.
Can a project involve multiple partners or jurisdictions?
Yes. Health systems may involve multiple partners and jurisdictions, potentially including States and localities, Tribal governments, universities and colleges, hospitals, nonprofit organizations, faith-based and community-based organizations, and Federal agencies.
Is there a requirement related to being a long-established legal entity?
Yes. A key requirement is that applicants share a long-established legal entity as the sponsor.
Is there a requirement related to service volume or statistical power?
Yes. Applicants must have sufficient service volume to provide the statistical power needed to evaluate the intervention credibly.
Are for-profit organizations eligible to receive an award directly?
No. Under AHRQ's authorizing statute (42 USC 299c-5(c)), awards can be made to public and nonprofit entities. Other organizations can participate only as subcontractors.
Can foreign institutions participate?
Foreign institutions are limited to subcontractor roles, reflecting the program's focus on improving health care in the United States.
Are any organizations explicitly disallowed from participating?
Yes. Organizations classified under section 501(c)(4) that engage in lobbying are not allowed to participate.
Is cost sharing or matching required?
No. There is no cost-sharing or matching requirement for this opportunity.
When was the FOA posted and when were applications due?
The FOA was posted on October 20, 2009. The original and final application closing date was January 20, 2010. The archive date was February 20, 2010.
What CFDA program is associated with this opportunity?
The CFDA listing associated with the program is 93.226 (Research on Healthcare Costs, Quality and Outcomes).
What kinds of outcomes are projects expected to measure?
Successful projects would be expected to show measurable effects on patient safety outcomes, communication practices, timeliness and fairness of compensation where appropriate, and downstream liability-related outcomes such as claim patterns or administrative costs, with results that can be disseminated to inform broader adoption.
What is the overall approach encouraged by this opportunity?
The opportunity is built for large-scale, evidence-generating pilots that try to redesign how medical injuries are prevented and handled, linking patient safety improvements with better claims resolution processes.
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