Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set | HRSA 21 083

Opportunity Information: Apply for HRSA 21 083

The Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set opportunity (HRSA-21-083) is a Health Resources and Services Administration (HRSA) cooperative agreement released as a Special Project of National Significance. Its central purpose is to help states strengthen the practical, legal, and technical ability of HIV surveillance programs and Medicaid agencies to collect, link, and report accurate and complete HIV viral suppression data. The immediate reporting target is the HIV Viral Load Suppression measure for adults (HVL-AD) that states submit to the Centers for Medicare and Medicaid Services (CMS) as part of the Medicaid Adult Core Set, a standardized set of quality measures used to assess and improve Medicaid care. By improving the quality and consistency of these data flows, the broader aim is to support better health outcomes for people with HIV through clearer performance measurement and more reliable insight into where care systems are succeeding or falling short.

A major driver behind the project is the recognition that states often face real barriers to measuring viral suppression through Medicaid, even when lab data exist elsewhere in the public health system. The CMS Child and Adult Core Set Annual Review Workgroup encouraged stronger partnerships among CMS, the Centers for Disease Control and Prevention (CDC), HRSA, state Medicaid agencies, public health agencies, and managed care plans so states can access the laboratory data needed to calculate viral suppression properly. The notice also ties this work to recommendations from the HIV/AIDS Health Improvement Affinity Group (HHIAG), emphasizing cross-state learning and the sharing of lessons learned so improvements are not isolated to a small number of jurisdictions.

Rather than funding many states directly, HRSA planned to make a single award to one System Coordination Provider (SCP). The SCP serves as the hub organization responsible for selecting, funding, and coordinating work with up to 10 Ryan White HIV/AIDS Program (RWHAP) Part B jurisdictions (the term "states" here includes the District of Columbia) along with their associated HIV surveillance and Medicaid programs. In practice, the SCP is expected to organize the collaboration, set a structured improvement process, provide technical assistance, and help participating jurisdictions overcome common obstacles such as fragmented data systems, mismatched identifiers, restrictions on data sharing, and inconsistent workflows for producing and submitting HVL-AD results.

The project is organized around three main goals. First, during the implementation phase, the SCP helps up to 10 jurisdictions build the capacity to report high-quality viral suppression data to Medicaid and improve their annual HVL-AD reporting to CMS through the Adult Core Set. HRSA expects the SCP and states to use the Institute for Healthcare Improvement (IHI) Breakthrough Series Learning Collaborative Model, which is designed to accelerate improvement by having teams test changes, learn quickly, and share what works. A key feature of this model is continuous quality improvement using Plan-Do-Study-Act (PDSA) cycles, where states try small, practical changes, measure results, adjust, and scale successful approaches.

To reach that first goal, the notice highlights several categories of strategies states may implement and pilot. These include building clear work plans and governance structures to manage cross-agency coordination; creating end-to-end workflows that allow HIV viral load suppression data to be submitted and used for Medicaid measurement; developing or updating data-sharing and data-linkage documents such as agreements, memoranda of understanding, or standard operating procedures; and addressing legal, privacy, and confidentiality requirements that often slow or prevent sharing of sensitive HIV-related laboratory information. Technical strategies are also emphasized, such as using secure platforms, interoperability standards, and confidential matching algorithms to link datasets while protecting privacy. The SCP is also expected to encourage collaboration and run demonstration pilots that operationalize improved reporting, using the learning collaborative approach to spread workable solutions across participating states.

Second, the SCP must evaluate the initiative on an ongoing basis through a rigorous, mixed-method, multi-site evaluation. This means the project is not only about implementing changes, but also about documenting what was done, understanding why certain approaches worked (or did not), and producing credible findings that can guide other jurisdictions. Mixed methods implies combining quantitative information (such as completeness or timeliness of data, match rates, or reporting success) with qualitative insights (such as stakeholder feedback, implementation barriers, and policy constraints) to provide a fuller picture of capacity building in real-world state environments.

Third, the SCP is responsible for dissemination and replication during a sustainability and dissemination phase. HRSA expects the SCP to work with participating RWHAP Part B jurisdictions and HRSA staff to spread findings and lessons learned beyond the funded sites, reaching other states and jurisdictions that are not directly supported under this project. A specific required product is a Technical Toolkit that gives detailed, practical guidance for how states can set up data sharing and data linkages needed to report the HVL-AD measure to CMS as part of Adult Core Set reporting, along with lessons learned from the initiative. The notice also makes clear that improving the viral suppression data reported to the Medicaid Adult Core Set should align with public health reporting needs as well, noting that improved data should also be reported to CDC.

In terms of basic funding details, this was a discretionary cooperative agreement under CFDA 93.928, offered by the Department of Health and Human Services through HRSA. HRSA anticipated one award, with an award ceiling of $4,000,000. The notice was created on November 16, 2020, and had an original application closing date of February 16, 2021. Overall, the opportunity is designed to create a coordinated, test-and-learn pathway for states to solve the operational and governance problems that stand between existing HIV lab data and reliable Medicaid quality measurement of viral suppression, while ensuring the resulting methods can be sustained and reused nationally.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.928.
• This funding opportunity was created on Nov 16, 2020.
• Applicants must submit their applications by Feb 16, 2021. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $4,000,000.00 in funding.
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).

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