AHRQ Announces Interest in Research on Health Insurance Coverage, Access and Affordability

Notice Number: NOT-HS-14-004

Key Dates
Release Date: December 17, 2013

Related Announcements
None

Issued by
Agency for Healthcare Research and Quality (AHRQ)

Purpose

The mission of the Agency for Healthcare Research and Quality (AHRQ) is to produce the evidence that is needed to make health care safer, higher quality, more accessible, equitable, and affordable. AHRQ accomplishes this by working with HHS and other partners to make sure that the evidence is understood and used.

This Notice informs the research community that AHRQ intends to support research designed to develop the evidence that will facilitate improvements in access to health care, help moderate the growth in the cost of healthcare and improve affordability. Attention will be given to determining the effects and impact of the Affordable Care Act coverage expansions on access to care, health safety, quality and outcomes, disparities, financial security, labor market effects (including effects on job-lock, entrepreneurship, and part-time work), insurance offers and take-up, provider costs, and health spending.

Research Areas of Interest 

As evidenced by the passage of the Affordable Care Act (ACA), access to health insurance coverage remains a critical public policy issue. Health insurance helps people get timely access to medical care and protects them against the risk of expensive and unanticipated medical events. Accurate and informed public policy analysis and policy design require precise estimates of the size and composition of the insured and uninsured populations, as well as information on how demographic characteristics, economic factors and health insurance subsidies affect health plan eligibility, decisions to enroll in health insurance plans and trends in health care expenditures and affordability. Evaluation of the equity and stability of health insurance coverage requires information on the ease with which health insurance transitions are made and how satisfied individuals are with their plans and issues of affordability.

With this Notice, AHRQ encourages grant applications that propose research that focuses on the topics of health insurance coverage, access to care and health care costs with specific emphasis in the following areas:

  • What is the impact of Medicaid and Marketplace coverage expansions on enrollment, access, health care use and expenditures, healthcare disparities, affordability and outcomes?
  • What methods are most effective in persuading eligible people to purchase coverage in the Marketplace and to enroll in Medicaid?
  • How are the decisions that employers and employees make about employer-sponsored coverage (for both large and small employers), such as those related to plan characteristics, offer and take-up rates, affected by the ACA?
  • To what extent does churning of coverage between Medicaid and the Marketplace, and between being insured and uninsured create challenges for continuity of care, and what sorts of community-level responses have been most successful in mitigating those challenges?
  • How has the ACA affected the overall structure of the insurance market, including the availability of and enrollment in different types of plans and the mix of employment related versus individual coverage?
  • What effect has the ACA had on changes in cost-sharing arrangements and the composition of provider networks, and what effects, if any, have these changes had on access to care, patient outcomes, and health care expenditures?

Further Guidance

Timeliness of Results. Because the goal is to produce results that will be useful to public and private policy-makers, AHRQ is particularly interested in research efforts that yield timely findings, working with HHS and other partners in order to optimize the usefulness of the respective initiatives.

Priority Populations.  Priority populations continue to be an area of interest to AHRQ. For purposes of this Notice, priority populations include low-income patients and the uninsured along with AHRQ's other priority populations (children, women, elderly, racial and ethnic minorities, and individuals with special health care needs).

Use of Multiple Funding Mechanisms.  AHRQ will use standing grant mechanisms such as the R01, R03, R18, and K08 funding mechanisms to support research on health insurance coverage, access and affordability. The relevant general AHRQ Funding Opportunity Announcements for R01, R03, R18, and K08 mechanisms can be found at: http://www.ahrq.gov/funding/research/announcements/index.html.

Application Submission. Applicants should consider this Notice active until further notice. AHRQ will provide updates of new developments and research priorities as research budget information becomes available. Applications focused on areas identified in this Notice should be submitted on regular research grant receipt dates and will be reviewed by AHRQ's standing study sections. Information about the grant application process, including e-grant applications and the funding mechanisms noted above, can be found at http://www.ahrq.gov/funding/index.html.

Applicants are encouraged to contact the designated AHRQ staff early in the process of preparing their applications.

Applicants are encouraged to use relevant AHRQ, DHHS, and federal and non-federal public and private data resources to support these research efforts. Examples of such data may be the MEPS, HCUP, National Health Interview Survey (NHIS), Medicare and Medicaid data resources and other Departmental data resources http://healthdata.gov/.

Inquiries

Please direct all inquiries to:

Amy Taylor, Ph.D.
Agency for Healthcare Research and Quality (AHRQ)
Center for Financing, Access and Cost Trends (CFACT)
Telephone: 301-427-1660
Email: Amy.Taylor@ahrq.hhs.gov