	Scope and Methodology

To describe the process and criteria AHRQ used to award its $474 million  in Recovery Act CER funds, we reviewed relevant statutes as well as  documentation on the process and criteria AHRQ uses to (1) determine  the scientific and technical merit of grant applications and contract  proposals, and (2) select grant recipients and contractors. We reviewed  spending plans, which outline AHRQ’s and HHS’s plans for spending  Recovery Act funds. We interviewed AHRQ  and other HHS officials to learn about the processes and criteria they  used to select the grantees and contractors that received awards funded  with the $474 million in Recovery Act CER funds and to coordinate these  awards with other HHS agencies that also received Recovery Act CER  funds. We also interviewed AHRQ officials and a contractor to  understand how the agency plans to disseminate the results of CER  funded with Recovery Act funds and to obtain information on plans AHRQ  has for assessing the effectiveness of its dissemination efforts. CER and the Recovery Act

The Recovery Act provided a significant amount of funding for AHRQ to  conduct CER activities. Of the total amount of  $474 million in Recovery Act funds available to AHRQ for CER,   $300 million of these funds were appropriated to the agency and,  therefore, supported the agency’s seven CER priority areas. AHRQ has established a  standard competitive process that is governed by federal law to select   According to AHRQ officials, this multistep process  grant recipients.includes: (1) an initial review of received applications; (2) preliminary  scoring of applications; (3) review and final scoring of applications at a  peer review panel meeting; (4) the development of preliminary funding  recommendations; (5) review by a senior leadership team within AHRQ;  and (6) a final determination of funding by the agency director. This process for selecting  contract proposals for award is governed by the Federal Acquisition  Regulation (FAR) and the Public Health Service Act (PHSA) and  implementing regulations.opportunities, which occurs through different types of solicitations, varies  depending on the type of contracting mechanism used. In addition, AHRQ primarily used its standard  contracting processes and criteria to select contract proposals and enter  into 34 contracts for CER using Recovery Act funding, totaling  approximately $161 million. AHRQ Used Its Standard Competitive Review Process and Criteria to Select Grant Recipients and Award 110 CER Grants

Between February 2009 and September 2010, AHRQ used its standard,  competitive grant review process to select grant recipients and ultimately  award 110 CER grants using approximately $311 million in Recovery Act  CER funds. $311 million in grants AHRQ awarded supported HHS’s departmentwide  and AHRQ’s agency-specific CER priorities. According to AHRQ officials, a review panel,  composed of external experts and AHRQ staff, evaluated all Recovery  Act CER contract proposals using the standard criteria that are tailored to  the specific needs of each contract solicitation. AHRQ Also Reported Taking Steps to Coordinate Recovery Act CER Awards with Other HHS Agencies to Avoid Unnecessary Duplication

AHRQ officials reported that they used five mechanisms in order to  coordinate with other HHS agencies to avoid unnecessary duplication  when creating FOAs for grants and solicitations for contracts and when  awarding Recovery Act CER funds. AHRQ Plans to Use Its Existing Mechanisms and Develop Additional Strategies to Disseminate CER Results

AHRQ plans to use a range of existing mechanisms, such as written  products, training, social media tools, and its website, to disseminate  results of CER funded through the Recovery Act. In addition, AHRQ awarded four contracts  using Recovery Act CER funds to develop and implement innovative  approaches for disseminating CER results, including Recovery Act- funded CER. Regional Dissemination and Partnership Offices. AHRQ provided technical comments, which we incorporated where  appropriate. AHRQ, formerly known as the Agency  for Health Care Policy and Research, is 1 of 12 agencies within the U.S.  Department of Health and Human Services (HHS).
Why GAO Did This Study

The American Recovery and Reinvestment Act of 2009 (Recovery Act) provided $1.1 billion to the Department of Health and Human Services (HHS) for comparative effectiveness research (CER), which is research that compares different interventions and strategies to prevent, diagnose, treat, and monitor health conditions. Of this amount, HHSs Agency for Healthcare Research and Quality (AHRQ) received $474 million to support and disseminate the results of CER. GAO was asked to describe issues including the (1) process and criteria AHRQ used to award Recovery Act funds for CER, including steps to coordinate CER awards with other HHS entities in order to avoid unnecessary duplication of effort; and (2) plans AHRQ has for disseminating the results of CER it funded under the Recovery Act.
To address these objectives, GAO reviewed relevant documentation, including AHRQs policies and procedures for selecting the recipients of grants; internal documents that describe the award of Recovery Act grants and contracts; and Recovery Act contractors work plans. GAO also analyzed AHRQ data on the number and type of grants and contracts awarded Recovery Act CER funds. GAO interviewed AHRQ officials on the selection of Recovery Act CER grantees and contractors, including coordination with other HHS agencies that received Recovery Act CER funds, and the plans the agency has to disseminate the results of CER funded by the Recovery Act. AHRQ provided technical comments, which GAO incorporated as appropriate.

What GAO Found

AHRQ used its standard, competitive review processes and criteria to select the recipients of CER grants and contracts using Recovery Act funds. Specifically, to select the recipients of Recovery Act CER grants, AHRQ used its standard review process that includes peer review of grant applications, the development of funding recommendations by a team of senior officials within AHRQ, and final funding determination by the agencys director. As part of this process, AHRQ used its standard criteria to evaluate grant applications, as well as additional requirements that were specific to each funding opportunity. To select contractors who would receive Recovery Act funds, AHRQ used its standard contracting processes and criteria that are governed by the Federal Acquisition Regulation, which establishes uniform policies for acquisition of supplies and services by executive agencies, and the Public Health Service Act. These processes included an evaluation of all contract proposals using standard criteria adapted to the specific needs of each project. Between February 2009 and September 2010, AHRQ awarded $311 million of its $474 million in Recovery Act CER funds through 110 grants. AHRQ also awarded $161 million of its Recovery Act CER funding through 34 contracts. The contracts and grants AHRQ awarded supported both AHRQs agency-specific and HHSs departmentwide CER priority areas. In an effort to avoid unnecessary duplication of CER awards, AHRQ participated in HHS working groups, developed a CER spending plan, and queried HHS databases to check for duplicative awards.
According to AHRQ officials, the agency plans to disseminate the results of Recovery Act-funded CER using a range of existing mechanisms. These mechanisms include written products, training programs, social media tools, and AHRQs website. AHRQ is also developing additional strategies to disseminate CER results. AHRQ awarded four contracts using Recovery Act funds totaling approximately $42.3 million to promote innovative approaches for disseminating CER results. A variety of efforts are conducted under these contracts, including efforts to educate clinicians and develop regional dissemination offices.