Healthcare Funding Forecasting

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WEBINAR BRIEFING Featuring Hanover Research Grants Consultant Sarah Ott, M.S. And Hanover Research Grants Consultant Teresa Wilke, MBA Healthcare Development Center Research Without Limits 2013 Hanover Research

OVERVIEW The topic of healthcare funding forecasting is of great importance as grantseekers aim to have the most up-to-date information about funding trends and future grant opportunities. By providing a comprehensive analysis of trends in healthcare funding, this webinar provided valuable information and resources to new and experienced grantseekers alike. Sharing insight with grantseekers about recent funding trends as well as forecasting upcoming funding opportunities, this webinar highlighted the value of staying connected and being in the know. The Webinar is a component of a recurring offering by Hanover Research to share up-to-date funding forecasting strategies. CONTENT & PRESENTERS Strategies to access trends and forecast upcoming healthcare grant funding opportunities were presented by Sarah Ott and Teresa Wilke of Hanover Research. KEY CONTENT The webinar featured both general best practice strategies to better understand and forecast funding opportunities and specific resources that provide a wealth of information on both trends and upcoming opportunities. Below are several items of key content from the webinar. SOURCES OF GRANT FUNDING AND INFLUENCES ON RESEARCH AGENDAS Three major sources of healthcare grant funding are the federal government, philanthropic foundations, and corporate foundations. Within the federal government, major sources of healthcare funding include the National Institutes of Health, Center for Medicare and Medicaid Services, Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Patient- Centered Outcomes Research Institute (PCORI), and U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA). In addition to federal funding, both philanthropic foundations and corporate foundations are major sources of healthcare funding. Major philanthropic foundation funders include The Commonwealth Fund, The Kresge Foundation, the Bill and Melinda Gates Foundation, and the Robert Wood Johnson Foundation. Major corporate foundation funders include Bayer, Pfizer, and CVS Caremark. PRESENTERS Amy Moynihan Content Manager Hanover Research Sarah Ott Grants Consultant Hanover Research Teresa Wilke Grants Consultant Hanover Research When we talk about predicting specific grant opportunities, we really need to step back and consider the influence of agenda setting research and how the findings of that research catalyze movement and spur investment across sectors. Teresa Wilke In addition to understanding the sources of health care grant funding, it is also important to consider the influences of agenda setting research. Reports released by large organizations or foundations can often serve as catalysts for 2

action across research, government, and practice communities by recommending protocol changes, identifying system issues, and framing what is innovative. As these major reports often influence the trends across the health care sector, following the key findings of major reports will also provide you with an understanding of trends to come in upcoming grant opportunities. Understanding how ideas in the research community ultimately influence both foundation and federal grant opportunities provides insight into the influences on grant opportunities. The following image demonstrates the steps from idea generation in the research community to subsequent grant opportunities. In response to agenda setting research, private foundations have the ability to move more quickly than the federal government. This is particularly true if the grant-making foundation sponsors the research. However, some foundations take the tactic of waiting to see first how the government will respond and then seeking to fill gaps not addressed by the government. Following the publication of research, federal grant funding priorities are also influenced by congressional leadership of both political parties, and executive agency administrators who have considerable latitude in interpreting and refining competitive grant programs. Just as grant seeking has become much more sophisticated, so has grant making. Private foundations and federal agencies have figured out how to use grant mechanisms to target specific priorities and conduct work in specific ways to further their own agendas. HOW TO BE IN THE KNOW A key takeaway from this presentation is that in order to be in the know, you must be proactive in respect to seeking funding sources rather than reactionary. Sharing tips for grant seekers to be more connected to a 3

variety of sources of information, the presenters outlined several strategies to help you stay in the know. The Federal Register Grants.gov LinkedIn Twitter RSS feeds Google grants alerts Email listservs Funding agency websites, including HHS Grants Forecast, and HRSA, CDC, IHS, SAMHSA, OPHS, and NIH Informal communications such as blogs and presentations Industry associations and professional networks including newsfeeds, conferences, and listservs THE IMPACT OF THE ACA AND FEDERAL BUDGET APPROPRIATIONS ON HEALTHCARE FUNDING When discussing current healthcare related funding opportunities, it is imperative to discuss the impacts of the Patient Protection and Affordable Care Act (ACA). The ACA seeks to expand coverage, control health costs and improve health care delivery systems. By driving people into the health system in more predictable ways, it is hoped that providers will be better able to contain costs, use data and help patients maintain wellness throughout the lifespan. This has resulted in several themes for federal and private foundation grant funding including: Improving health care access Driving people into the health system in predictable ways Promoting community and workplace wellness and preventive care Supporting technology- assisted communication and decision making Emphasizing care transitions and care coordination across delivery settings Fostering better management of chronic and mult-morbid conditions Incentivizing providers to improve efficiency and control costs The ACA regulations signal to private foundations how they can support improvements in care delivery, but also foreshadow how the landscape will change and where gaps may exist in funding or methodology to achieve the goals of the ACA. The federal government shutdown in October impacted grant funding mechanisms. As none of the federal agencies were able to publish grant solicitations or conduct technical assistance during the shutdown, the deadlines for several grants programs were delayed (such as at HRSA) and over 200 grant review meetings at NIH were rescheduled, resulting in up to a four month delay in funding decisions. The current Continuing Resolution will expire on January 15, 2014 and it is yet to be seen how the upcoming budget negotiations may affect specific funding mechanisms like those under ACA. Since we are heading into a mid-term election year for all House members and 33 Senators, and the Affordable Care Act has become a proverbial line in the sand for many politicians, grant programs under the ACA will likely be highly politicized even more than normal. TRENDS ACROSS HEALTH FUNDING SECTORS Major trends identified in both the federal and private sector are better care, healthy people and healthy communities, and affordable care. Trends were divided into system and community focused trends. 4

System-focused areas are those which take place within the walls of the hospital or system whereas community-focused areas are programs that can use to affect patients in their own environment. On a system level, four notable trends were identified: 1. The use of IT infrastructure to capture, analyze and share data to improve care. This includes point of care decision making. The goal is to make physicians, nurses and other health professionals decisionmaking easier. 2. The improvement of communication and coordination among providers across care sites. Our healthcare system is often fragmented, with patients, families, and caregivers forced to navigate an increasingly complex and inefficient system. Lack of care coordination can lead to medication errors, preventable hospital readmissions, and unnecessary pain and suffering for patients. 3. Improving the through-put efficiency of care delivery, particularly in the ED and urgent/retail care. Policymakers, private payers, and system leaders are looking for ways to reduce waste, increase the efficiency of health care delivery, and allocate resources to improve value in health care. Changing the way we deliver health care will require process redesigns that improve quality and limit cost growth. 4. Training and workforce development focused on interprofessional teams and patient-centered medical home. Healthcare professionals and organizations, policy makers, and the public are calling for safe and effective care that is centered on patients' needs, values, and preferences. Continuing professional development is urgently needed to help healthcare professionals acquire the knowledge, skills, and attitudes necessary to create and sustain a culture of collaboration. On the community level, three trending areas were highlighted. They include: 1. Integrating preventive care programs across sectors using existing supports (school, home, community, care site). Clinical preventive services can be supported and reinforced by community-based prevention, policies, and programs. It is also important that individuals be informed of existing community services that support health promotion, such as exercise programs, educational classes, self-management training, and nutrition counseling. 2. Creating Healthy Environments (built environments) from a community-wide perspective. The Institute of Medicine has asserted that the public health system should fulfill society s interest in assuring conditions in which people can be healthy. Consider promoting changes in the built environment that can impact public health, including the addition of greenspace, sidewalks, and bike paths. 3. Communication /Care coordination. This includes the active engagement of patients with chronic illnesses while hospitalized; following patients intensively post-discharge; teaching / coaching patients about medications, self-care, and symptom recognition and management; and reminding / encouraging patients to keep follow-up physician appointments. SELECTED UPCOMING OPPORTUNITIES A variety of both private and corporate funding opportunities as well as federal government opportunities were presented to provide participants with an overview and selected information on upcoming funding opportunities. The information provided below is intended to highlight funders that are investing in the trending areas discussed throughout the presentation. In addition to the information provided, all of the foundations and agencies have excellent online resources for more detailed information on funding priorities and upcoming opportunities. 5

Upcoming private and corporate funding: The Commonwealth Fund The Commonwealth Fund was established in 1918 and seeks to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for the most vulnerable. Over a five year period (2012-2017), The Commonwealth Fund projects spending $162 Million to support this mission. The Fund seeks to maintain a portfolio in which each year 20 percent of funded projects come from unsolicited proposals and also that 20 percent of funds support investigators that are new to the Fund. Agenda priorities include: Health Care Coverage and Access Focus on coverage gaps that will not be addressed by the health reform law Health Care Delivery System Reform Payment reform Primary care Coordinated Care Systems Medicare International Health Policy and Practice Innovations Breakthrough Health Care Opportunities Organizational Models Care Delivery Processes Emerging Technologies Incentives The Hearst Foundations The Hearst Foundations is comprised of two foundations founded by William Randolph Hearst, that operate as one entity one, sharing the same funding guidelines and staff. From 2010 to 2011, this foundation s giving increased 39% from $24.5 to $34.1M. The Hearst Foundations support education, health, culture and social services. Although health is only one aspect of its giving, in recent years, about 30% of total funding has been allocated to health programs. The foundations tend to give to larger health organizations with budgets over $10 Million (comprising 80% of health grantees). Funding priorities include: Professional development Programs improving access to high-quality healthcare for low-income populations Programs developing and providing specialized care for the complex needs of elderly populations Programs scaling innovative healthcare delivery systems to provide efficient, coordinated care Research, particularly related to finding new cures and treatments for prevalent diseases, such as cancer The Kresge Foundation For over 85 years, the Kresge Foundation was known for capital challenge grants to nonprofit organizations. However, about five years ago, the Kresge Foundation shifted to a more policy and program-focused giving structure. The Kresge Foundation is now a $3 billion foundation that focuses on a range of issues including improving the health of low-income people. 6

In the arena of health, the Kresge Foundation has a priority of reducing health disparities by promoting conditions and environments that lead to positive health outcomes. The Kresge Foundation: Seeks to promote the health and well-being of low-income and vulnerable populations through engagement of these communities. Gives preference is for projects that have wide potential reach and influence. Prefers cross-sector, multifold projects that address environmental and social conditions or policy change. Does not fund direct clinical services. The Robert Wood Johnson Foundation With funding concentrated most heavily in the Northeast and Mid-Atlantic, the Robert Wood Johnson Foundation focuses on human capital funding including clinical research on topics such as stroke, heart failure, obesity, and PTSD. The majority of human capital funding from this foundation focuses on under-represented groups including ethnic minorities and individuals with disabilities. Funding priorities include: Childhood obesity- 171 awards totaling $170,313,934 Coverage for uninsured- 81 awards totaling $52,647,298 Human Capital/Investing in people to improve health- 382 totaling $210,793,656 Fostering pioneering ideas- 45 awards totaling $32,423,392 Improving the public s health- 218 awards totaling $194,167,075 Advancing health care quality- 97 awards totaling $74,366,811 Helping the most vulnerable populations- 128 awards totaling $146,008,525 In addition to private foundations, corporate foundations are investing in many of the trending fields discussed in this presentation. Funding opportunities by Bayer, Pfizer, and CVS Caremark were discussed to demonstrate the ways in which corporate foundations fund trending initiatives. Upcoming Federal funding: U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) The Health Resources and Services Administration is the primary federal agency focused on improving access to health care and support of direct care delivery. HRSA has been given a major role under the Affordable Care Act as the agency is responsible for 50 individual provisions under the law, which falls primarily into categories of: expanding the primary care safety net, training the next generation of primary care professionals and expanding prevention and public health efforts. 7

Upcoming HRSA competitions include: Office of Rural Health Policy Rural Health Network Planning (Open 11/14; Due 1/14) Rural Health Services Outreach (Summer/Fall 2014) Bureau of Health Professions NEPQR (Open 11/22; Due 1/24) Primary Health Care ACA Capital Development (Open 12/4; Due 3/5) New Access Points (Open 12/11; Due 1/15) HIV/AIDS Bureau System-Level Workforce Capacity Building for Integrating HIV Primary Care in Community Healthcare Settings-Demonstration Sites (Open 1/16; Due 3/17) Patient- Centered Outcomes Research Institute (PCORI) PCORI is an independent non-profit, research-focused organization authorized by the ACA. So far, PCORI has committed over $273 million to 197 projects. PCORI review panels are unique in that they include both scientist reviewers as well as patients and stakeholders. The proposals to PCORI are scientific research projects, but they should be written so that both scientists and lay people can understand them because of the unique dynamics of the review committee. The PCORI research agenda includes: Assessment of prevention, diagnosis and treatment options Improving healthcare systems Communication and dissemination of research Addressing disparities Improving methods for conducting patient-centered outcomes research Centers for Disease Control and Prevention (CDC) The Center for Disease Control and Prevention s mission is health promotion through health information dissemination. According to the Centers for Disease Control and Prevention Fiscal Year 2012 Grants Summary Profile Report for U.S. States and District of Columbia, the top five areas of funding in 2012 for the CDC includes vaccines for children (50.5 percent), infectious diseases (17.3 percent), public health preparedness and emergency response (10.2 percent), chronic disease prevention and health promotion (8.3 percent), and prevention and public health fund/ other ACA funds (7.7 percent). The top funded area that relates most to the discussed trends is Chronic Disease Prevention and Health Promotion with the most funded diseases/prevention measures being: 1. Cancer, 2. Tobacco, 3. Diabetes, 4. Heart Disease and Stroke, and 5. Safe Motherhood and infant health. National Institutes for Health (NIH) As the largest source of funding for medical research globally, the National Institutes of Health (NIH) is responsible for distributing more than $30 billion a year to support researchers. The most common type of award provided by the NIH is the R01, which is one of a number of Research Project Grants (RPGs). This is offered alongside other research project grants such as the R15 offered to those at educational institutions that have not been major recipients of NIH research grant funds, and the R21 grant which is intended to 8

encourage exploratory/developmental research by providing support for the early and conceptual stages of project development. In addition to RPGs, the NIH offers a variety of awards aimed at research centers, small businesses and Research Career Awards also referred to as K grants, and individual and institutional training awards. NIH trends over time show that the areas with highest spending have only seen modest increases in funding since 2009. The NIH reports that the following research/ disease areas were the highest funded areas in 2012: Clinical research, genetics, biotechnology, prevention, cancer, neurosciences, brain disorders, and infectious diseases. Agency for Healthcare Research and Quality (AHRQ) AHRQ reports the following research funding priorities: Career development (k08) and dissertation (r36) grants focused on health information technology (IT) Patient-centered outcomes research (PCOR) mentored career development grants focused on methodologies and research in translation, implementation, and diffusion of research into practice and policy Research to improve diagnostic performance in ambulatory care settings Policy relevant evaluations to inform development of health information technology (IT) meaningful use objectives Priority populations research Health issues of minority women Healthcare-associated infections POLLING RESULTS Several live polls during our webinar provided invaluable information on the grantseeking activities at the institutions of our webinar participants. A majority of participants (60 percent) who responded noted that their institution is currently exploring or planning to explore both federal and foundation grants. When asked to identify the types of grant opportunities that are difficult to locate, the highest percentage of participants (33 percent percent) responded that foundation opportunities are the most difficult to locate, followed by federal opportunities (26 percent) and both federal and foundation opportunities are difficult to locate (26 percent). When asked with which of the trends discussed during the presentation do participants need more support with, the responses with the highest percentage of participants were Healthy Community (Community focused trend) 52 percent, Efficient Care Delivery (System focused trend) 38 percent, followed by Communication and Care Coordination (System focused trend) 31 percent, Training/ Workforce Development (System focused trend) 31 percent, and Preventive Care (Community focused trend) 31 percent. BIOGRAPHIES Amy Moynihan (Host) Amy Moynihan is a Content Manager at Hanover Research. Amy is currently a Ph.D. candidate in Higher Education at The University of Virginia, Curry School of Education. She also holds a M.Ed. in Social Foundations from The University of Virginia, Curry School of Education and a B.A. from Columbia University. 9

Sarah Ott Grants Consultant, Hanover Research Sarah Ott, M.S., has ten years of grant writing experience. Prior to coming to Hanover, she worked at two large academic health sciences centers (WVU, UTHSCSA), working in interdisciplinary community-health-related centers with faculty and physicians from many different specialties. Sarah has the most grant writing experience in the post-secondary education and health and human services arenas. She has predominantly written grants for the following funding agencies: NIH (R21, R01, R37, U54), HRSA (R40), CDC, AHRQ, and U.S. Department of Education funding opportunities. Sarah has secured over $16.7M grant dollars. Teresa Wilke Grants Consultant, Hanover Research Teresa Wilke, M.B.A., has over 15 years of experience in program design, project management and strategic communications, including 10 years of experience developing grant proposals and grant seeking strategies for universities and hospitals. Teresa has worked in several federal agencies and executive departments, including the White House, HUD, EPA, and the EEO Commission. She has also been a director of sponsored programs at a large regional public university and coordinator of an NIH-funded research center. She has secured over $9.8M in new grants for nursing and science education, laboratory and health facility renovations, health literacy, patient support and rural health projects. One of the most important aspects in writing a winning grant proposal is ensuring that you have plenty of time to write a quality proposal. The best way to do that is to stay informed about funding opportunities so that you are one of the first to know when an opportunity is announced. -Sarah Ott When you learn of a new report from the IOM, RWJF, or these very large foundations like the Kaiser Family Foundation, it is worth taking the time to at least the review Executive Summary and share the findings with your program staff, because these will, ultimately, influence grant opportunities down the road. -Teresa Wilke Moving outside the walls of the hospital and exploring what we can do for patients out in their own community is appealing to funders of all types. In the community area, there are three areas where we are seeing funding increases: preventive care, healthy community, and communication and care coordination. -Sarah Ott Just as federal grantmakers have become more savvy about using grants to further their agendas, so have private foundations. There are a number of characteristics of a competitive grant application, but we want to highlight one trend in private foundation giving and that is leveraging assets. This means both leveraging the resources and investments of other funders and vertically investing in the entire cycle of an initiative, from pilot, to full implementation, to evaluation and through dissemination. This has been a basic tenet of successful grant seeking for several years, but it has really reached a new level in terms of the expectation for targeted, purposeful leveraging of different funding streams, as well as long-term investments being driven by grantmaking foundations. -Teresa Wilke 10

LEARN MORE Headquartered in Washington, DC, Hanover Research is a global research and grant development firm providing solutions to higher education, healthcare organizations, hospitals, K-12, municipalities, and other non-profit organizations. We work with executives and their teams across a cost-effective partnership to help them better understand and pursue external funding in the face of increased competition for funding with government and private entities. To view the recorded webinar, open the following link http://hanoverresearch.adobeconnect.com/p9749d7cd5k/ For more information on Hanover Research s grant services, check out our capabilities at http://www.hanoverresearch.com/health-care-foundationgrants-development/ District Healthcare Administration Development Practice Center Research Without Limits 2013 Hanover Research