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Content provided by the Catalog of Federal Domestic Assistance
93.226 Research on Healthcare Costs, Quality and Outcomes




Public Health Service Act, Section 902, Public Law 106-129, 42 U.S.C. 299 et seq.
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To support research and evaluations, demonstration projects, research networks, and multidisciplinary centers and to disseminate information on health care and on systems for the delivery of such care involving: (1) The quality, effectiveness, efficiency, appropriateness and value of health care services; (2) quality measurement and improvement; (3) the outcomes, cost, cost-effectiveness, and use of health care services and access to such services; (4) clinical practice, including primary care and practice-oriented research; (5) health care technologies, facilities and equipment; (6) health care costs, productivity, organization, and market forces; (7) health promotion and disease prevention, including clinical preventive services; (8) health statistics, surveys, database development, and epidemiology; and (9) medical liability. In support of this research, the Agency has a special interest in health care and its delivery in the inner city, in rural areas, and for priority populations (low-income groups, minority groups, women, children, the elderly, and individuals with special health care needs).


Project Grants.
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The research should contribute to the health services knowledge base from which empirically based information can be derived by policymakers, both immediately and over the coming decades. Grants include funds for direct costs (such as personnel, travel, equipment, or supplies) necessary to carry out an approved project as well as funds for the reimbursement of applicable facilities and administrative costs. Unallowable costs, as well as those for which prior written approval is required, are indicated in the PHS Grants Policy Statement. Discretionary funds are available.


Applicant Eligibility:   Federal, State or local government agencies, federally-recognized Indian Tribal Governments, U.S. Territories, sponsored organizations, non-government organizations, minority groups, specialized groups, public or private institutions of higher education, and other public or nonprofit private agencies, institutions, or organizations. Research project grants may also be awarded to individuals. For-profit organizations are eligible to apply for these grants only if "cooperative agreement" is the designated funding mechanism. Organizations described in section 501(c)4 of the Internal Revenue Code that engage in lobbying are not eligible.

Beneficiary Eligibility:   Federal, State or local government agencies, federally-recognized Indian Tribal Governments, public or private nonprofit institutions, U.S. territories, Native American organizations, sponsored organizations, consumers, students, minority groups, specialized groups, health or education professionals, individuals, scientist/researchers, and the general public.

Credentials/Documentation:   Nonprofit organizations must submit proof of their nonprofit status when applying for grants. Costs will be determined in accordance with DHHS Regulations 45 CFR 74.

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Pre-application Coordination:   There is no program requirement for preapplication. Informal preapplication consultation to prospective applicants is available upon request, but is not required. This program is excluded from coverage under E.O. 12372.

Application Procedure:   For nongovernmental applicants, Form PHS- 398 (Rev. April 1998), should be submitted. For State and local governments, the standard application forms, as furnished by PHS and required by 45 CFR Part 92, may be used. For State agencies, no State Plan is required. Applications are reviewed and evaluated by a group composed primarily of nonfederal scientists. The review is conducted by a panel of experts in the specific study area proposed. This program is subject to the provisions of 45 CFR Part 92 for State and local governments and OMB Circular No. A-110 for nonprofit organizations.

Award Procedure:   Following review for scientific merit by a group composed primarily of nonfederal scientists, grant applications may be reviewed by the National Advisory Council for Healthcare Research and Quality, after which AHRQ makes final decisions to support approved applications. When such decisions are made, applicants are notified directly by AHRQ staff and all required steps are taken to issue the Notice of Grant Award, Form PHS-5152-6 (Rev. December 1999).

Deadlines:   New grants (except R03 mechanism): February 1, June 1, October 1. Competing continuations and competing supplements: March 1, July 1, November 1. New AIDS grants: May 1, September 1, January 2. R03 grants: March 24, July 24, November 24.

Range of Approval/Disapproval Time:   From 6 to 9 months from receipt of application.

Appeals:   None.

Renewals:   If additional support is desired to continue a project beyond the approved project period, an application for competing continuation must be submitted for review in the same manner as a new application.


Formula and Matching Requirements:   This program has no statutory formula or matching requirements.

Length and Time Phasing of Assistance:   Grants may be approved for project periods up to 5 years. Awards are made on an annual basis and it is expected that obligations will be made within the budget period awarded. After awards are issued, funds are released in accordance with the payment procedure established by the grantee institution with DHHS, which may be an Electronic Transfer System or a Monthly Cash Request System.


Reports:   Progress reports are required on an annual basis. Financial Status Reports must be submitted within 90 days after the end of each budget period. Inventions are to be reported immediately. A terminal progress report must be submitted within 90 days after the end of a project.

Audits:   In accordance with the provisions of OMB Circular No. A- 133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. In addition, grants and cooperative agreements are subject to inspection and audits by DHHS and other Federal government officials.

Records:   Records must be retained for at least three years; records shall be retained beyond the three year period if audit findings have not been resolved.


Account Identification:   75-1700-0-1-552.

Obligations:   (Grants) FY 01 $142,027,519; FY 02 est $147,200,000; and FY 03 est $83,800,000.

Range and Average of Financial Assistance:   $10,174 to $3,998,451; $333,225 average. These are total cost figures (direct costs plus associated facilities and administrative costs, if appropriate).

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In fiscal year 2001, 403 grants were provided to universities, hospitals, nonprofit private agencies, State agencies, local government agencies and individuals to conduct health services research and demonstration projects. In fiscal year 2002, it is estimated that approximately 420 grants will be provided to similar organizations and individuals for the support of extramural health services research and demonstration and dissemination projects. In fiscal year 2003, it is estimated that approximately 250 grants will be provided to similar organizations and individuals.


42 CFR 67, Regulations for Grants for Health Services Research, Evaluation, Demonstration, and Dissemination Projects as amended by P.L. 106-129; PHS Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000 (Rev.) April 1, 1994.


Regional or Local Office:   Not applicable.

Headquarters Office:   George Gardner 5600 Fishers Lane, Rockville, Maryland 20857 Phone: 301-427-1447

Web Site Address:


(1) Centers for Education and Research on Therapeutics; (2) Primary and Secondary Prevention of CHD and Stroke; (3) Improving Pain Management in Nursing Homes; (4) Optimizing Antibiotic Use in Long-Term Care; (5) Improving the Delivery of Effective Care to Minorities; (6) Risk-Adjustment of 1-Year Health Status Outcomes in CAD; (7) Impact of Early Discharge Following Bypass Surgery; (8) Smoking Control in MCH Clinics: Dissemination Strategies; (9) Benefits of Regionalizing Surgery for Medicare Patients.


The proposals must first be reviewed by review groups of peers and recommended for approval on the basis of scientific and technical merit. This includes consideration of the qualifications of the principal investigator and staff to conduct the research using appropriate methodology and budget. Applications may be reviewed for program relevance by the National Advisory Council for Healthcare Research and Quality. Those approved proposals which are most relevant to the identified program priority issues of the AHRQ are funded to the extent that funds are available.

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