This notice announces the opportunity to apply for funding under the Small Health Care Provider Quality Improvement Program (Rural Quality Program). The purpose of the Rural Quality Program is to support planning and implementation of quality improvement activities for rural primary care providers or providers of health care services, such as a critical access hospital or a rural health clinic, serving rural residents. These activities include providing clinical health services to residents of rural areas by funding projects that coordinate, expand access, contain costs, and improve the quality of essential health care services.
The program goal is to promote the development of an evidence-based quality improvement culture and to promote the delivery of cost-effective, coordinated health care services in primary care settings. Successfully funded projects will enhance the delivery of health care in rural areas and demonstrate improvements in: 1) patient health outcomes for the rural communities served and 2) the delivery and quality of essential rural health care services by the end of the three-year period of performance. Additional objectives of the program include enhanced chronic disease management and increased engagement of patients and their caregivers.
In alignment with the Department of Health and Human Services’ (HHS) and Health Resources and Services (HRSA) priorities and current rural health care needs, the FY 2019 Rural Quality Program additionally requests project proposals focus on rural chronic disease management and/or the integration of mental/behavioral health services into the rural primary care setting. You are also strongly encouraged to incorporate quality improvement initiatives that align with Patient-Centered Medical Home (PCMH) and Value-Based Care Delivery (VBC) approaches to care. Both PCMH and VBC apply the concepts of systematic and continuous quality improvement and will help position award recipients to provide high quality, affordable and accessible patient-centered health care services.1, 2
Although it is not a requirement, HRSA strongly encourages applicants to form a consortium or network for this program. As health care delivery becomes an increasingly collaborative environment, HRSA finds the formation of partnerships for community-based projects an effective way to meet rural community needs, enhance organizational roles, and expand critical health care services and rural delivery systems. Further, consortia and networks can contribute great value to quality improvement initiatives through leveraging shared resources, information, and participation in incentive programs rewarding health care professionals for the provision of preventive and quality care services.
Funding under this program may be used to provide start-up funds for quality improvement initiatives that allow recipients to develop the necessary capacity and ability to obtain funding from other sources. Awarded organizations are not required to, but are permitted, to use funds to obtain or maintain nationally recognized
1 Agency for Healthcare Research and Quality Patient Center Medical Home Resource Center. Defining PCMH. Accessed June 1, 2018 from: https://pcmh.ahrq.gov/page/defining-pcmh.
2 New England Journal of Medicine. January 1, 2017. What is Value-Based Healthcare? Accessed June, 2018 from: https://catalyst.nejm.org/what-is-value-based-healthcare/.
quality improvement accreditation such as, PCMH by the National Committee for Quality Assurance (NCQA), among others. Applicants that are health departments and/or partner with health departments are particularly encouraged to pursue such accreditation.
HRSA also recognizes how the focus on value among public and private insurers may further serve strategies for post-funding project sustainability. You are encouraged to consider leveraging value-based payment and reimbursement structures for maintaining proposed projects at the conclusion of federal funding, if awarded. Please refer to this NOFO’s Project Narrative Methodology section A. Goals and Objectives and C. Sustainability Approach for more information and additional guidance on this topic.
HRSA recognizes rural health care organizations often provide a variety of essential health care services and, if awarded, does not restrict applicants from expanding or replicating proposed project activities as part of implementation efforts during the three-year period of performance. For additional information and guidance, please refer to the instructions included in the Project Narrative section.
Eligible applicants must be a rural public or rural nonprofit private health care provider or provider of health care services, such as a critical access hospital or a rural health clinic; or network of small rural providers; and must not previously have received an award under this subsection for the same or similar project. For the purposes of this program, “health care provider” may include, but is not limited to, entities such as black lung clinics, hospitals, public health agencies, home health providers, mental health centers and providers, substance abuse service providers, rural health clinics, primary care providers, oral health providers, social service agencies, health profession schools, local school districts, emergency services providers, community health centers/federally qualified health centers, tribal health programs, churches, and civic organizations that are providing health care services.