Delivery System Research Initiative

Improving the way that care is delivered is critical to the drive to reform health care so as to ensure its quality and enhance its efficiency and affordability. To achieve these goals, the public and private sectors are experimenting with promising new ways to deliver and pay for care. Rigorous research is needed to determine the most effective forms of system design and improvement approaches, under what circumstances they are effective and for whom, and what it would take to scale up the more promising new forms of delivery. AHRQ has a long history of support for this type of research and has several recent or ongoing funding initiatives.

• Accelerating the Dissemination and Implementation of PCOR Findings into Primary Care Practice (R18).
• Disseminating Patient Centered Outcomes Research To Improve Healthcare Delivery (R18).
• Accelerating Change and Transformation in Organizations and Networks II: Fact Sheet.

Between 2009 and September 2013 AHRQ awarded 10 grants on delivery system research and the spread of evidence-based practices through delivery systems. These grants were funded by the American Recovery and Reinvestment Act (ARRA) ) (refer to ARRA Delivery System Initiative: Background and Funded Applications (Text Version) ; Research Awards [2.2 and 2.3] and Dissemination, Translation, and Implementation Awards [2.1].

Study Snapshots

• Methods and Outcomes of Care Management Programs Within Physician Organizations vs. Plan-Based Programs (PDF File, 148.09 KB).
• Implementation and Impact of Medicare's Voluntary Ambulatory Care Quality Reporting Program (PDF File, 97.68 KB).
• Variation in the Implementation of California's Full-Service Partnerships for Persons With Serious Mental Illness (PDF File, 80.89 KB).
• The IHA Bundled Episode Payment and Gainsharing Demonstration (PDF File, 147.94 KB); Methods Appendix (PDF File, 74.35).

Grantee Presentations and Publications

Select for presentations and publications that describe the ARRA Delivery System projects and report their results.

Research Abstracts

Abstracts of research funded under the Delivery System Initiative:

• Physician Quality Reporting and Patient Outcomes in Medicare
  Principal Investigator: Bryan Dowd, Ph.D., Division of Health Policy and Management, School of Public Health, University of Minnesota
• Impact of Medicaid Policy on Cardiovascular Drug Use and Clinical Outcomes
  Principal Investigator: Michael A. Fischer, M.D., M.S., Brigham and Women’s Hospital
• A Comparison of Provider versus Health Plan Delivered Care Management in Michigan
  Principal Investigator: Jodi Summers Holtrop, Ph.D., MCHES, Michigan State University
• Primary Care Practice Redesign—Successful Strategies
  Principal Investigator: Michael K. Magill, M.D., University of Utah, School of Medicine, Department of Family and Preventive Medicine
• The IHA Bundled Episode Payment and Gainsharing Demonstration Project
  Principal Investigator: Tom Williams, Dr.P.H., Integrated Healthcare Association

For additional information, contact: Michael.Harrison@ahrq.hhs.gov