It is no surprise that funding for research—and for health research in particular—is declining.  Whether lower funding is the result of the health care crisis, sequestration implications, or both, federal agencies, research institutions, and foundations increasingly have to prioritize projects and make difficult fiscal decisions. Despite the challenges that are associated with more limited funding, Russell Glasgow of the National Cancer Institute believes that one silver lining is that the tough times are forcing people to think more in terms of a “systems approach” to health care.  Across government agencies, non-profit organizations, academic institutions and foundations, groups are attempting to harmonize the measures and data they have and making those data sources publicly available. In the Sunday “Funding Priorities” meeting track, funders explained how their respective agencies are prioritizing projects, while attempting to lower costs:

    • National Institutes of Health - Robert Kaplan, in "The Health Services Research Agenda and Funding Opportunities at the National Institutes of Health" session said that, in the social sciences portfolio of NIH, there are five subcategories that have been chosen for closer focus: prevention, social epidemiology, measurement development, decision science, and mHealth. When asked how NIH is prioritizing activities after the sequester, Kaplan said there was an intention to focus more on patients with multiple chronic conditions, and he's hopeful that NIH will see more of this work in the years to come. At the National Heart, Lung, and Blood Institute (NHLBI), the director has made clear that the number one priority is traditional R01s, or investigator-initiated grants. Steven Clauser of the National Cancer Institute (NCI) also echoed the importance of investigator-initiated research. At NCI, discretionary spending, such as travel, is being cut drastically to honor the commitment to research. Institution grants will be scaled down. In addition, NHLBI special advisor George Mensah is attempting increase the Institute’s work in implementation research, while still keeping the overall budget down. As for current funding opportunities, NIH recently announced a trans-NIH Dissemination and Implementation Research in Health grant. Participating institutes include NIMH, NIDA, NCI, NIAID, NHLBI, and NNR. Russell Glasgow urged all attendees interested in dissemination and implementation work to look into this opportunity.
    • Foundations - Several of the panelists in “Foundations’ Research and Policy Agendas” articulated that their respective organizations were working in the health reform. Kimberly VanPelt of St. Luke’s Health Initiatives said a big focus of the organization was the implementation of the Affordable Care Act (ACA) and moving Arizona forward with Medicaid expansion. Lisa Sugarman of The SCAN Foundation also indicated her organization was working on the integration of Medicare and Medicaid. Debra Perez of the Robert Wood Johnson Foundation,  noted that although RWJF’s portfolio is diverse, there is currently a focus on quality/equality, big data, and utilization. Finally, Judith Meyers, Child Health & Development Institute, said a focus area for her organization has been on integrated tools, specifically in mental health.  The overarching mission of the organization - communicating research to policymakers - is still the priority, and the Child Health & Development Institute is currently working with academic foundations and other institutions to continue that mission, moving research from “the bedside to the community.”
    • Center for Medicare and Medicaid Innovation - CMMI, according to Gerald Riley, Office of Research, Development, and Information at CMS, in a session “Center for Medicare and Medicaid Innovation Research Agenda,” highlighted the many programs in which the center is currently involved. Current projects include Partnership for Patients and models that target the Medicaid programs, such as the Strong Start for Mothers and Newborns Initiative. One current funding opportunity is the second round of Health Care Innovation Awards, which fund “projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.” Letters of intent for the project are due on June 28 by 3:00 p.m.
Across sessions, panelists recognized there was frustration about receiving funding for research. Times are tough economically, and the future is uncertain. However, there are more opportunities for innovation and utilization than ever before. For example, the notion of “big data,” is currently seen as a challenge, but it can also provide an outlet for conducting research for big projects at relatively little cost. Through innovation and collaboration, and with a greater number of tools and resources, panelists at NIH are optimistic about the role of HSR in the years to come.
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