Special Emphasis Notice (SEN): Health Services Research Priorities for Achieving a High Value Healthcare System

Notice Number: NOT-HS-19-011

Key Dates
Release Date : February 25, 2019

Related Announcements

Issued by
Agency for Healthcare Research and Quality (AHRQ)


The purpose of this Notice is to inform the research community that the Agency for Healthcare Research and Quality (AHRQ) is interested in receiving health services research grant applications to advance our national goal of achieving a high value healthcare system.  This effort supports the HHS-wide Value-Based Transformation Initiative and its four primary focus areas:

  • Patients as empowered consumers
  • Providers as accountable patient navigators
  • Payment for outcomes
  • Prevention of disease

AHRQ encourages applications to respond to the following specific areas:

1.  Patients as empowered consumers  

Research on:

  • Expanding access to account-based care such as Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Medicare Medical Savings Accounts (MSAs), including:
  • Financial structures that empower consumers such as HSAs, HRAs, and MSAs and the impact on health care use, quality, and cost
  • The role of information and health information technology in empowering consumers to make informed decisions regarding costs, treatment alternatives, and prevention in these plans
  • Price and quality transparency, including:
  • Use of price and quality information by patients to make informed decisions
  • Optimal interfaces/tools to support informed decision making
  • Usable, ‘shoppable’ units of care to measure quality and price in a way that will be easily understood by patients

2.  Providers as accountable patient navigators

Research on:

  • Reinventing primary care
  • Best practices and tools (decision aids) for providers and consumers to be engaged in shared decision making to promote informed decisions, increase patient engagement, and improve quality of care, costs, and health outcomes
  • Transforming kidney care
  • Potential barriers related to living donor kidney donation such as increased clinical risks (hypertension) and associated costs, and potential financial structures to offset disincentives
  • Incentives to decrease the discard rate on organs from deceased donors
  • Patient-centered tools can empower providers and patients to manage kidney diseases across care settings, including home care
  • Interventions to prevent kidney disease progression

3.  Payment for outcomes

Research on:

  • Direct contracting
  • Impact of provider financial incentives on quality and costs of care
  • Impact of third party financial incentives on quality and costs of care
  • Variation in impact between different types of contracts and types of providers (for example, capitation or bundle approaches with different specialists and primary care physicians)
  • Addressing workforce supply shortages
  • State and federal guidelines, standards of care, and other requirements related to non-physician providers’ impact on quality of care, cost, and outcomes
  • Best practices and innovations to increase workforce mobility, including telehealth, to allow providers to more easily meet the needs of patients

4.  Prevention of disease

Research on:

  • Addressing social determinants of health  
  • Effective interventions (addressing social, economic, and clinical factors) that improve the health of individuals
  • Integration of support structures such as food, housing, transportation, and behavioral health with clinical care and the impact on medical spending and health outcomes
  • Data and analytic methods, including EHRs and HIEs, that will support clinicians and health care organizations to identify and address social determinants of health in coordination with clinical care
  • The role of partnerships between the community and health systems in impacting social determinants of health and improving health outcomes
  • Improving health for children ages 0-3 and intergenerational approaches to promoting child and family health
  • Factors influencing racial/ethnic disparities in infant and maternal health outcomes, including access to care, quality of care, and system fragmentation
  • Approaches to optimizing delivery of care (e.g., care coordination, systems integration of medical-social factors, innovative payment models) to address chronic health conditions in mothers and to reduce adverse infant and maternal health outcomes
  • Role of maternal care experiences in variations in quality of care, costs, and maternal and infant health outcomes
  • Utilizing Artificial Intelligence (AI) to unlock insights into health care data
  • Methods of incorporating AI-derived insights into health care delivery
  • Best practices in the use of AI for the purposes of enhancing predictive analytics
  • Factors that impact the trust of providers in AI-derived predictions

AHRQ has a particular interest in health service research applications that address the experience, needs, preferences, and outcomes of priority populations including children and adolescents, women, older adults, people with chronic medical conditions, racial and ethnic minorities, low-income, and rural populations.

The Agency encourages research teams to submit applications in response to this emphasis using AHRQ’s standing R18, R03, and R01 funding mechanisms (PA-18-793, PA-18-794, PA-18-795). AHRQ also is interested in receiving career development awards (PA-16-223 and PA-17-232) that propose developing generalizable health service research skills through projects related to the value-based transformation efforts. 

Applicants should clearly state in their cover letter and project summary of their grant application that they are responding to this SEN by including the title and number of this SEN (NOT-HS-18-015).  Applications responding to this SEN should be submitted on regular application receipt dates identified in the respective Funding Opportunity Announcement and will be reviewed by AHRQ standing study sections. Applicants should consider this SEN active until September 30, 2021.


Please direct all inquiries to:

The Office of Extramural Research, Education, and Priority Populations (OEREP)