Key Dates

Related Announcements

• April 24, 2024 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Required) See NOFO PA-24-181
• April 24, 2024 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Not Allowed) See NOFO PA-24-182
• April 24, 2024 - Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Required) See NOFO PA-24-175
• April 24, 2024 - Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Not Allowed) See NOFO PA-24-176
• April 24, 2024 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required) See NOFO PA-24-193
• April 24, 2024 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Not Allowed) See NOFO PA-24-194
• April 9, 2024 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required) See NOFO PA-24-184
• April 9, 2024 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed) See NOFO PA-24-185
• January 13, 2023 - Innovative Pilot Mental Health Services Research Not Involving Clinical Trials (R34 Clinical Trial Not Allowed) See NOFO PAR-23-105
• January 6, 2023 - Innovative Mental Health Services Research Not Involving Clinical Trials (R01 Clinical Trials Not Allowed) See NOFO PAR-23-095
• March 2, 2021 - Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01 Clinical Trial Required) See NOFO PAR-21-130
• March 2, 2021 - Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 Clinical Trial Required) See NOFO PAR-21-131
• May 7, 2020 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required) See NOFO PA-20-194
• May 7, 2020 - NIH Small Research Grant Program (Parent R03 Clinical Trial Not Allowed) See NOFO PA-20-200
• May 5, 2020 - Research Project Grant (Parent R01 Clinical Trial Required) See NOFO PA-20-183
• May 5, 2020 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) See NOFO PA-20-185

Issued by

National Institute of Mental Health (NIMH)

National Institute on Drug Abuse (NIDA)

Purpose

This NOSI seeks to promote research to examine the impact of financing and payment mechanisms on behavioral health services access, utilization and outcomes.

Background

Groundbreaking legislation has increased access to behavioral health services by facilitating payment mechanisms. For example, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA), signed into law in 2008, has increased access to care for millions of persons with behavioral health conditions, by preventing health insurers from providing less generous benefits for mental health and addiction services than those offered for general medical care. In 2010, the Patient Protection and Affordable Care Act (PPACA) further expanded access to health care, including mental health and addiction services, through a number of initiatives, including Medicaid expansions, state health insurance exchanges, individual and small-employer subsidies and mandates.

Even with this expanded access to insurance coverage, access to effective behavioral health services remains limited. Policymakers continue to develop numerous innovations, generally initiated at the federal, state, or tribal levels, that may facilitate payment or reduce the cost of behavioral health services. Some examples include (but are not limited to):

• 1915 (c) Home and Community Based Services waivers and 1915 (i) Small Plan Amendments
• Community Mental Health Services Block Grant
• Substance Use Prevention, Treatment and Recovery Services Block Grant
• State Opioid Response Grants
• Billing codes (e.g., for collaborative care and integrated physical and behavioral health services)
• Value-Based Insurance Design, which uses financial incentives to incentivize high-quality or high-value care
• Pay for success initiatives.
• State Family First Prevention Services Act plans
• Bundled payments (e.g., payments under the Medicare Opioid Treatment Program benefit)
• Paid sick leave mandates, which may facilitate access to medical and behavioral health services
• State or local policies, examples include (but are not limited to)
  • Arizona: 3% cap on interest for medical debt
  • Washington, DC: Children covered on health benefit exchange will have no deductible and $5 copay, with no limit on the number of mental health visits
• Policies related to the distribution of funds from opioid medication settlements.
• Funding strategies such as ear-marked taxes or tax credits

Goal

The aim of this NOSI is to support research to understand when and to what extent financing mechanisms, policies, and regulations optimize patient-level outcomes, including access, utilization of services, as well as behavioral health outcomes.

For the purpose of this NOSI, behavioral health services include prevention, treatment, and recovery support services.

Studies should not be merely descriptive but should seek to understand how, why, for whom, and/or in what circumstances the policy/intervention is effective or achieves desired outcomes.

High-priority studies will include clearly operationalized research-practice partnerships that inform study design and ensure findings can be readily put into practice.

Examples of high-priority research include, but are not limited to, the following:

• Identifying the impact of financing and payment mechanisms on behavioral health services access, delivery, utilization, functioning and quality of life, and the mechanisms of action, policy levers and other mutable factors, that influence these outcomes.
• Investigating new models of health care financing that promote high value (e.g., clinically effective and efficient) care and discourage low-value services, in an equitable manner that takes into account the risk adjustment of the patient population served.
• Identifying mutable factors of financing and payment mechanisms that can address disparities, as defined by NIH (https://www.nimhd.nih.gov/about/overview/).
• Examining the role of implementation of financing and payment mechanisms on outcomes, including feasibility, acceptability and fidelity.
• Examine impact of financing and billing strategies for telehealth, text, apps, and other technologies.
• Analyzing the impact of the policy, both positive and negative on other resources, e.g., the conditions under which “spillover effects”, iatrogenic or unintended consequences occur.
• Optimizing public and commercial financing mechanisms that cover integrated care, including integrated medical and psychosocial treatment approaches, and packages for individuals with complex needs (e.g., combination psychopharmacology, psychotherapy, rehabilitative therapy, care coordination interventions), including but not limited to, programs using the Collaborative Care model (CoCM), or Federally Qualified Health Centers (FQHCs).
• Studying incentives for behavioral health providers to accept insurance (versus self-pay) and the impact on patients’ access, utilization and outcomes.
• Studying the impact of national, state, provincial/county-level, or other health care system rules and regulations on participation in provider reimbursement and/or waiver programs.
• Understanding the role of financing and economic factors on developing and supporting a behavioral health workforce qualified to deliver evidence-based behavioral health services, and identifying ways to extend or increase the workforce to increase access to behavioral health services.
• Understanding the impact of economic factors affecting patients’ access to and ability to seek high-quality behavioral health services, and its impact on behavioral health outcomes.

All studies should have health outcomes and health-related behaviors as the primary focus (see NOT-OD-16-025). Studies without a direct tie to health within the study aims would generally be outside of NIH’s mission. Also note that no NIH funding should be used for any activity to advocate or promote any proposed, pending or future Federal, State or local tax increase.

All applications for NIDA funding should be aware of the Special Considerations for NIDA Funding Opportunities and Awards posted here: https://nida.nih.gov/funding/special-considerations-for-nida-funding

• Application and Submission Information

This notice applies to due dates on or after October 5, 2024, and subsequent receipt dates through October 15, 2027. 

Submit applications for this initiative using one of the following notice of funding opportunity (NOFO) or any reissues of these announcements through the expiration date of this notice.

• PA-24-181 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Required)
• PA-24-182 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Not Allowed)
• PA-24-175 - Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Required)
• PA-24-176 - Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Not Allowed)
• PA-24-193 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required)
• PA-24-194- NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Not Allowed) 
• PA-24-184 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required)
• PA-24-185 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed)
• PAR-23-105 - Innovative Pilot Mental Health Services Research Not Involving Clinical Trials (R34 Clinical Trial Not Allowed)
• PAR-23-095 - Innovative Mental Health Services Research Not Involving Clinical Trials (R01 Clinical Trials Not Allowed)
• PAR-21-130 - Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01 Clinical Trial Required)
• PAR-21-131- Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 Clinical Trial Required)
• PA-20-194 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)
• PA-20-200 - NIH Small Research Grant Program (Parent R03 Clinical Trial Not Allowed)
• PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
• PA-20-183 - Research Project Grant (Parent R01 Clinical Trial Required)

All instructions in the SF424 (R&R) Application Guide and the notice of funding opportunity used for submission must be followed, with the following additions:

• For funding consideration, applicants must include “NOT-MH-24-270” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Although NIDA is not listed as a Participating Organization in all the NOFOs listed above, applications for this initiative will be accepted.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Please direct all inquiries to the Scientific/Research, Peer Review, and Financial/Grants Management contacts in Section VII of the listed notice of funding opportunity.

Scientific/Research Contact(s)

Jennifer Humensky, PhD
National Institute of Mental Health/Division of Services and Intervention Research
Telephone: 301-480-1265
Email: [email protected]

Tamara Haegerich, Ph.D.
Division of Epidemiology, Services, and Prevention Research
National Institute on Drug Abuse
Telephone: 301-443-1185
Email: [email protected]