This announcement solicits applications for the Small Health Care Provider Quality Improvement Grant Program. The purpose of the Small Health Care Provider Quality Improvement Grant (Rural Quality) Program is to provide support to rural primary care providers for implementation of quality improvement activities. Quality health care is the provision of appropriate services to individuals and populations that are consistent with current professional knowledge, in a technically competent manner, with good communication, shared decision-making and cultural sensitivity. The ultimate goal of the program is to promote the development of an evidence-based culture and delivery of coordinated care in the primary care setting. Additional objectives of the program include: improved health outcomes for patients; enhanced chronic disease management; and better engagement of patients and their caregivers.
Organizations participating in the program are required to utilize an evidence-based quality improvement model, perform tests of change focused on improvement, and use health information technology (HIT) to collect and report data. HIT may include an electronic patient registry (EPR) or an electronic health record (EHR), and is a critical component for improving quality and patient outcomes. With HIT it is possible to generate timely and meaningful data, which helps providers track and plan care. It is expected that applicants have implemented an HIT system by the time of award. Implementation is defined by the Office of the National Coordination for Health Information Technology as installation of the system and associated activities, such as training, mock “go-live,” and pilot testing. This program does not support funding for an EHR, but grantees may use funds to develop or purchase a module or interface or customize reports to support collection of data. If any applicant plans to use an EHR for this program, it is highly recommended that the product is certified by the Office of the National Coordinator for Health Information Technology: (http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__standards_and_certification/1153).
The Rural Quality Program supports three years of funding. During the first year of the program, grantees will complete implementation of any additional HIT needed for data collection, train staff on data collection and the evidence-based quality improvement model, begin collecting, testing and validating data, and begin implementation of quality improvement initiatives and tests of change. Grantees are expected to report baseline clinical data by six (6) months after the project period start date. During year two, grantees will continue reporting clinical data, using data to guide quality improvement initiatives, and work on sustainability, culminating in submission of a final sustainability plan by the end of the year. During the third and final year, grantees will continue reporting data, identify another condition or disease to begin quality improvement activities once federal funds have ended, and continue work on sustainability.
Although it is not a requirement, the Office of Rural Health Policy (ORHP) is strongly encouraging applicants to form a consortium or network for this program. The health care system is becoming increasingly collaborative, and organizations will need to form partnerships and leverage resources to participate in many incentive and payment programs. Through other grant programs, ORHP has found that consortia and networks can better meet community need, enhance each organization’s role, and stabilize and expand needed services and rural delivery systems.
Sustainability of project activities beyond the funding period is a priority of the ORHP. It is expected that participation in this program will help prepare organizations to continue their quality improvement programs, participate in for pay-for-performance and other incentive programs, such as Patient-Centered Medical Home, Meaningful Use, and Accountable Care Organizations. Grantees will also be required to submit a final sustainability plan at the end of the second year that includes an additional health indicator they plan to target for quality improvement and data collection once federal funds have ended. The plan should explain why the health indicator was selected.
Under health services delivery programs, HRSA funding may serve as seed money to allow recipients to develop necessary capabilities and the ability to obtain funding from non-Federal sources. Recipients must maximize funding from other sources, using award funds for the difference between those amounts and their costs of operation. Therefore, applicants must describe whether other funding sources and/or services currently exist for the proposed population and, if so, how HRSA funds would be used.
To the extent possible, grantees are encouraged to bill for third party reimbursement for covered services in order to focus program dollars on the training of staff in quality improvement activities to build a culture of quality within their organization that will aid in the sustainability of the project beyond Federal funding.