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.Apply for HRSA 21 083
- 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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Frequently Asked Questions (FAQs)
What is the “Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set” opportunity (HRSA-21-083)?
It is a Health Resources and Services Administration (HRSA) Special Project of National Significance (SPNS) cooperative agreement designed to strengthen how states collect, link, and report HIV viral suppression data for Medicaid quality measurement, with a focus on improving accuracy and completeness of reporting.
What is the main purpose of this cooperative agreement?
The central purpose is to help states improve the practical, legal, and technical capacity of HIV surveillance programs and Medicaid agencies to collect, link, and report accurate and complete HIV viral suppression data, especially for Adult Core Set reporting to the Centers for Medicare and Medicaid Services (CMS).
Which specific measure is the immediate reporting target?
The immediate target is the HIV Viral Load Suppression measure for adults (HVL-AD), which states submit to CMS as part of the Medicaid Adult Core Set.
What is the Medicaid Adult Core Set?
The Medicaid Adult Core Set is a standardized set of quality measures used to assess and improve Medicaid care. HVL-AD is one of the measures states report to CMS through this framework.
Why is this project needed if viral load lab data already exist in public health systems?
The opportunity is driven by the reality that states can face barriers to measuring viral suppression through Medicaid even when laboratory data exist elsewhere, due to challenges like fragmented data systems, mismatched identifiers, limits on data sharing, and inconsistent workflows for calculation and submission.
How does the opportunity encourage cross-agency and cross-organization partnerships?
It reflects recommendations from groups such as the CMS Child and Adult Core Set Annual Review Workgroup and the HIV/AIDS Health Improvement Affinity Group (HHIAG), emphasizing stronger partnerships among CMS, CDC, HRSA, state Medicaid agencies, public health agencies, and managed care plans, plus cross-state learning to share lessons and scalable approaches.
Who receives the funding under this opportunity?
HRSA anticipated making a single award to one System Coordination Provider (SCP), rather than funding many states directly.
What is a System Coordination Provider (SCP) in this project?
The SCP is the hub organization responsible for selecting, funding, and coordinating work with up to 10 Ryan White HIV/AIDS Program (RWHAP) Part B jurisdictions and their associated HIV surveillance and Medicaid programs.
How many jurisdictions can participate in the initiative?
Up to 10 RWHAP Part B jurisdictions can participate. In this context, “states” includes the District of Columbia.
What kinds of organizations or programs within a state are expected to be involved?
The work is intended to link and strengthen collaboration across state Medicaid agencies and HIV surveillance programs, and it also highlights the importance of relationships with public health agencies and managed care plans as part of improving access to laboratory data needed for proper HVL-AD calculation.
What are the main goals of the project?
The project is organized around three main goals: (1) implementation support to build capacity and improve HVL-AD reporting to CMS; (2) ongoing rigorous, mixed-method, multi-site evaluation; and (3) dissemination and replication through a sustainability and dissemination phase, including development of a Technical Toolkit.
What improvement approach is HRSA expecting jurisdictions to use?
HRSA expects the SCP and participating jurisdictions to use the Institute for Healthcare Improvement (IHI) Breakthrough Series Learning Collaborative Model, which is designed to accelerate improvement through shared learning and rapid testing of changes.
What are PDSA cycles and how do they fit into the project?
PDSA (Plan-Do-Study-Act) cycles are a continuous quality improvement method where teams test small changes, measure results, learn from the outcomes, refine the approach, and scale what works. The opportunity describes PDSA cycles as a key feature of the learning collaborative approach.
What types of barriers is the project intended to help jurisdictions overcome?
The project is designed to address barriers such as fragmented data systems, mismatched identifiers used across datasets, restrictions on data sharing, legal and privacy requirements tied to sensitive HIV-related data, and inconsistent workflows for producing and submitting HVL-AD results.
What kinds of strategies may jurisdictions implement and pilot to improve reporting?
The notice highlights multiple categories of strategies, including creating work plans and governance structures for cross-agency coordination; building end-to-end workflows for submitting and using viral suppression data for Medicaid measurement; developing or updating data-sharing and data-linkage documents (such as agreements, MOUs, or SOPs); addressing legal, privacy, and confidentiality requirements; and applying technical approaches such as secure platforms, interoperability standards, and confidential matching algorithms.
What does “end-to-end workflow” mean in this context?
It refers to establishing a complete, practical process that allows HIV viral load suppression data to move from where it exists (for example, surveillance or laboratory reporting systems) into a form that can be used for Medicaid quality measurement and then submitted to CMS for HVL-AD reporting.
What kinds of documents are mentioned as part of improving data sharing and linkage?
The opportunity mentions documents such as data-sharing agreements, memoranda of understanding (MOUs), and standard operating procedures (SOPs) to support consistent, legally and operationally sound data exchange and linkage.
How does the project address privacy and confidentiality concerns?
It emphasizes the need to address legal, privacy, and confidentiality requirements that can slow or prevent sharing HIV-related laboratory information, and it highlights technical methods such as secure platforms and confidential matching algorithms intended to protect privacy while enabling linkage.
What is meant by a “mixed-method, multi-site evaluation”?
It means the SCP is expected to evaluate the initiative using both quantitative and qualitative approaches across multiple participating jurisdictions. The evaluation is intended to document what was implemented, assess what worked or did not, and generate credible findings that can inform other jurisdictions.
What kinds of quantitative data might be used in the evaluation?
The notice gives examples such as completeness or timeliness of data, match rates across datasets, and reporting success for HVL-AD.
What kinds of qualitative information might be included in the evaluation?
Examples include stakeholder feedback, implementation barriers, workflow challenges, and policy or legal constraints that affect data sharing and reporting.
What is expected during the dissemination and sustainability phase?
The SCP is expected to help spread findings and lessons learned beyond the funded jurisdictions, supporting replication by other states and jurisdictions not directly supported by the project.
What is the required “Technical Toolkit”?
A required product is a Technical Toolkit that provides detailed, practical guidance for how states can establish the 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.
Does the opportunity connect Medicaid reporting to public health reporting?
Yes. The notice states that improving viral suppression data reported to the Medicaid Adult Core Set should also align with public health reporting needs, and it notes that improved data should also be reported to the Centers for Disease Control and Prevention (CDC).
Which federal agency is offering the award?
The award is offered by the Department of Health and Human Services through HRSA.
What type of funding mechanism is this?
It is a discretionary cooperative agreement (HRSA SPNS cooperative agreement).
What is the CFDA number associated with this opportunity?
The opportunity is listed under CFDA 93.928.
How many awards did HRSA anticipate making?
HRSA anticipated making one award to a single System Coordination Provider (SCP).
What was the award ceiling?
The award ceiling was $4,000,000.
When was the notice created and when was the original application closing date?
The notice was created on November 16, 2020, and the original application closing date was February 16, 2021.
What is the broader aim beyond improving HVL-AD reporting?
Beyond HVL-AD reporting quality, the broader aim is to support better health outcomes for people with HIV by improving performance measurement and providing more reliable insight into where care systems are succeeding or falling short.
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