Recovery Act 2009 Limited Competition OS ARRA Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient (R21) | Apply Online

FAQs: RFA-HS-10-009 (AHRQ) ARRA Comparative Effectiveness Research for the Complex Patient (R21)

1. What is this funding opportunity?

This was a limited-competition funding opportunity from the Agency for Healthcare Research and Quality (AHRQ) under the American Recovery and Reinvestment Act of 2009 (ARRA). It supported exploratory and developmental research using the NIH R21 grant mechanism.

2. What is the official funding opportunity number and title?

The funding opportunity number was RFA-HS-10-009. The title was "Recovery Act 2009 Limited Competition OS ARRA Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient (R21)."

3. What was the central aim of the research?

The central aim was to generate early, practical evidence on comparative effectiveness for medically complex patients, particularly people living with multiple chronic conditions that interact with one another.

4. What types of patients were the focus of this FOA?

The focus was on patients with multiple chronic conditions (multi-morbid patients), especially where co-morbidities interact and create complex, real-world decisions about prevention, treatment, and long-term management.

5. How is this different from research focused on a single disease?

Instead of studying one condition in isolation, this FOA emphasized real-world clinical situations where patients have specific constellations of co-morbidities. The intent was to understand how best to prevent and manage chronic illness when multiple diseases are present at the same time.

6. What did AHRQ mean by "comparative effectiveness" in this context?

In this FOA, comparative effectiveness referred to comparing different strategies for preventing and managing chronic illness in complex patients, and clarifying which approaches provide the most value under different patterns of co-morbidity.

7. What kinds of research questions was the FOA trying to answer?

The FOA aimed to produce evidence that helps answer questions such as which preventive services should come first for a patient with several chronic diseases, which therapies should be paired or avoided, how care should be sequenced, and what care coordination approaches lead to better outcomes and safer care.

8. What areas of care integration were emphasized?

AHRQ emphasized understanding how to integrate care across conditions, including how clinicians should prioritize interventions, time them appropriately, and coordinate services across providers and settings.

9. Did the FOA address safety concerns in patients with multiple chronic conditions?

Yes. A key theme was that the effectiveness and safety of interventions can change when co-morbid conditions are present, including whether medication combinations increase risk and whether interventions need modification for certain multi-morbid patient populations.

10. Did the FOA encourage evaluating whether standard treatment guidelines still apply?

Yes. The FOA highlighted the need to assess whether standard treatment guidelines remain appropriate when other diseases are present, and whether preventive services should be adjusted due to competing risks or burdens.

11. What kinds of delivery or care models were within scope?

The FOA referenced care coordination and integration approaches, including delivery models such as coordinated primary care and specialty care, when those models could improve results for complex patients.

12. What was the intended impact for clinicians?

For clinicians, the research was meant to support better integration of care, reduce fragmented decision-making, and improve coordination across multiple conditions.

13. What was the intended impact for patients?

For patients, the goal was to strengthen the evidence base needed for informed choices about care options, including tradeoffs, burdens, and risks that may differ for people managing multiple illnesses at once.

14. What was the intended impact for policymakers and health system leaders?

For policymakers and health system leaders, the FOA aimed to support better measurement and promotion of quality care for complex patients, recognizing that conventional quality metrics and disease-specific performance measures often do not fit multi-morbidity well.

15. What type of grant mechanism was used?

The FOA used the NIH R21 grant mechanism and was intended to support exploratory and developmental research.

16. What was the source of funding for this opportunity?

This was a discretionary grant program funded through the American Recovery and Reinvestment Act of 2009 (Public Law 111-5), using AHRQ funds to accelerate evidence generation.

17. How much total funding did AHRQ estimate for this FOA?

AHRQ estimated total funding at $6,000,000.

18. Was cost sharing or matching required?

No. The FOA did not require cost sharing or matching.

19. Who was eligible to apply (based on the information provided)?

Eligibility included state governments, county governments, city or township governments, public and state-controlled institutions of higher education, and tribal governments (including federally recognized tribal governments and other Indian/Native American tribal organizations). The eligibility language also noted additional eligible applicants, including certain federal government agencies and faith-based or community-based organizations, with an instruction to consult the full announcement for details and any clarifications related to the limited-competition nature of the call.

20. What does "limited competition" imply here?

The FOA was described as a limited-competition opportunity. The eligibility section included a prompt to consult the full announcement for details and any clarifications tied to that limited-competition structure.

21. When was the FOA posted and created?

The announcement was posted and created on December 17, 2009.

22. What was the application closing date?

The application closing date was January 20, 2010.

23. When was the opportunity archived?

The FOA was archived on February 20, 2010.

24. Where could applicants find the full announcement?

The full announcement was made available through the NIH grants guide at http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-10-009.html.

25. Who was listed for technical access and linking support?

Technical access and linking support was directed to the NIH Office of Extramural Research webmaster at FBOWebmaster@OD.NIH.GOV.