Deborah Rogal

1
Changes in Health Care Financing and Organization
(HCFO) An Initiative of The Robert Wood Johnson
Foundation Program Overview June 2005
Deborah Rogal Senior Manager, AcademyHealth
Deputy Director, HCFO Program
2
Overview of Presentation

• HCFO Program Purpose and History
• Grantmaking
• Convening and Dissemination
• HCFO website www.hcfo.net

3
HCFO Program Purpose

• Generate usable and timely information on health
  care policy and financing issues.
• Support research projects that provide decision
  leaders with information about significant issues
  and interventions related to health care
  financing and organization and their effects on
  health care costs, quality, and access.
• Support policy relevant research where findings
  are likely to fill a gap in knowledge, make a
  unique contribution to the field, advance the
  field, and contribute to policy debate in the
  private or public sector.

4
HCFO Program History

• 16th Year
• Reauthorized five times since its inception in
  1989
• Re-authorized in April 2005 for 10 million over
  3 years

5
Grantmaking

• As of May 2005, the program has awarded 235
  grants 51 are active.
• In the past five years, approximately 37 of
  brief proposals were invited to submit full
  proposals.
• In the past five years, approximately 36 of full
  proposals became grants.
• All funded projects place an emphasis on how
  current public and private mechanisms for
  financing health care, or proposed major changes
  in those mechanisms, will affect health care
  costs, access, or quality.

6
Types of Projects

• Research and Policy Analysis
• Design and analyze major health care financing
  strategies and issues
• Examine the effects of financing and
  organization strategies on costs, access,
  quality, and the market
• Evaluation and Demonstration
• Assess major strategies and policies already
  in place
• Test new strategies with the potential to
  improve access to more affordable health care
• Quantitative
• Includes analysis of primary and secondary
  data sets
• Qualitative
• Includes case studies, focus groups, and
  synthetic analyses

7
Market Phenomena of Interest

• Increasing consumer role in health care
  decisions
• Components of the delivery system that make a
  difference in quality of care and health outcomes
  (e.g., individual providers, hospitals, the
  system) and
• Impacts of significant changes in health
  insurance benefit design.

8
Examples of Possible Projects

• Analyses of how consumers use information to make
  decisions, and the impact of those decisions on
  costs, satisfaction, and quality of care
• Simulations of various delivery system changes
  and
• Examination of the implications of health
  insurance benefit design changes for consumers,
  employers, health plans, and providers.

9
Topics Under Consideration for Future Meetings
and/or Special Solicitations

• Medical Malpractice
• Consumer Information
• Public Health Systems
• Administrative Simplification
• Quality

10
Selection Criteria

• Policy Significance of the health care financing
  policy or issue being assessed
• Uniqueness of the project
• Quality and availability of the data to be used
  and the strength of the proposed methodology
• Applicants experiences and qualifications and
  the time commitment of key project staff members
  who have the skills and experience to perform the
  various operations and analytic tasks required.
  Special consideration will be given to project
  teams evincing collaboration among researchers
  and policymakers, health plan officials,
  purchasers, or providers, whether in the private
  or public sectors
• Other criteria, specific to individual
  proposals,
• may be considered at the discretion of the
  reviewers.

11
Ongoing Solicitation
Call for Proposals is Active (apply online
www.hcfo.net)

• Small grants
• Require up to 100,000 and projected to take 12
  months or less.
• Most often awarded for
• Quick turn-around policy analyses that are judged
  to be of great use to policy-makers
• Projects using case-study data to assess the
  early impacts of newly implemented major
  policies and
• Analyses of data collected under larger projects
  where critical questions have arisen after the
  project and its original analyses have been
  completed.
• Larger grants
• Require more than 100,000 and/or projected to
  take longer than 12 months.

12
Technical Assistance for Grantees

• Before a proposal is submitted, HCFO staff
  respond to inquiries regarding
• Requirements for application,
• Nature of topics that might be considered within
  HCFOs scope, and
• Approach to research.
• From the time a proposal is submitted until a
  funding decision is made
• Critical questions are asked and modifications
  may be recommended, and
• Technical reviewers, in consultation with
  AcademyHealth and The Robert Wood Johnson
  Foundation, may identify some applicants who meet
  the selection criteria, but would benefit from
  technical assistance on the proposed projects
  methodology. Outside expertise on research design
  and methodological matters may be made available
  to these applicants.

13
Technical Assistance for Grantees

• Over the course of the grant, to ensure
  successful completion of the project, HCFO staff
  
• Monitors progress over the course of the grant,
• Conducts grantee briefings,
• Works with grantees to overcome obstacles, and
• Reviews papers.
• After completion of the project, HCFO staff
  strongly emphasizes dissemination of findings
  through
• Peer-reviewed journals,
• HCFO publications,
• The program Web site, and
• Other vehicles that reach policymakers.

14
Web Site www.hcfo.net

15
National Advisory Committee
Robert Reischauer, Ph.D., Chair, The Urban
Institute Kathleen Buto, Johnson and
Johnson Robert Crane, Kaiser Permanente Jose
Escarce, M.D., RAND Marsha Lillie-Blanton,
Dr.P.H., Henry J. Kaiser Family
Foundation Harold Luft, Ph.D., University of
California, San Francisco Kathleen Means,
Patton Boggs, LLP Mark Pauly, Ph.D., University
of Pennsylvania Mark Peterson, Ph.D.,
University of California, Los Angeles Louis
Rossiter, Ph.D., College of William and
Mary Katherine Swartz, Ph.D., Harvard
University Joseph Thompson, M.D., University of
Arkansas Alan Weil, J.D., National Academy for
State Health Policy Designate, Ex Officio,
CMS Designate, Ex Officio, AHRQ