Comparative Effectiveness:

Agency for Healthcare Research and Quality's Process for Awarding Recovery Act Funds and Disseminating Results

GAO-12-332: Published: Feb 29, 2012. Publicly Released: Mar 30, 2012.

Additional Materials:


Linda T. Kohn
(202) 512-7114


Office of Public Affairs
(202) 512-4800

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 agency’s 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 AHRQ’s agency-specific and HHS’s 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 AHRQ’s 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.

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, HHS’s 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 AHRQ’s 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.

For more information, contact Linda Kohn (202) 512-7114 or

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