by Lynn Shapiro Snyder, Lee H. Rosebush and Daniel G. Gottlieb

February 2010

On January 20, 2010, the Agency for Healthcare Research and Quality ("AHRQ") announced its Request for Proposal ("RFP") No. AHRQ-10-10005 entitled Accelerating Change and Transformation of Organizations and Networks ("ACTION II").[i] Letters of Intent are due March 1, 2010.Applications must be received by noon (ET) on March 23, 2010. AHRQ anticipates awarding 12 to 15 "cost reimbursement, multiple-award, task order-type contract[s] . . . for a period of five years, [t]hree years with one two-year option."[ii]

"The goal of ACTION II is to promote and accelerate the development, implementation, dissemination, and sustainability of evidence-based innovation in health care delivery and organization to measurably improve health care in the U.S."[iii] ACTION II seeks to achieve four objectives by focusing on practice-based research. The four objectives are as follows: "Implementation of a proof of concept . . . ; Implementation of an innovation or improvement approach . . . ; Spread or the taking to scale, of one or more proven innovations or delivery system improvements . . . ; and Sustainability."[iv]


AHRQ is the federal agency within the U.S. Department of Health and Human Services ("DHHS") whose mission is to improve the quality, safety, efficiency, effectiveness, and cost-effectiveness of health care for all Americans by developing and working with health care systems: 1) to reduce the risk of patient harm from health care services using evidence-based research and technology; 2) to achieve broad access to effective services while promoting the efficient use of resources; and 3) to improve health care outcomes by encouraging providers, consumers, and patients to use evidence-based information to make informed treatment decisions.

In 2006, AHRQ launched an initiative entitled Accelerating Change and Transformation in Organizations and Networks ("ACTION"). The goal of ACTION is to address innovations in health service delivery that can be spread and sustained. The 15 Partnerships that participate in ACTION include over 140 collaborating organizations. According to AHRQ, ACTION has been highly successful in "foster[ing] public-private collaboration and incorporate[ing] best practices into health care delivery."[v]

Since the launch of ACTION in 2006, there has been an increased demand for practice-based research endeavors in the health care delivery arena. ACTION II seeks to answer this demand by awarding 12 to 15 ACTION II Partnerships. While being named an ACTION II Partnership does not guarantee research funding, it does provide funding opportunities as only these 12 to 15 Partnerships will be eligible to submit task order proposals.

Who is eligible to apply?

AHRQ is seeking proposals from collaborative Partnerships that will include, among others, health care research organizations, health care delivery systems, health plans, academic medical centers, consulting firms, Quality Improvement Organizations, governmental health care organizations, employers, state and local government health care agencies, community-based collaboratives, and consumer advocacy groups. While the composition of the providers is not a part of the scoring criteria, AHRQ notes that it is particularly interested in Partnerships that include "a substantial number of primary care providers interested in participating in ACTION II implementation research."[vi] However, AHRQ notes that it "hopes to achieve overall diversity across the network of Partnerships selected for awards."[vii] Additionally, there are "no restrictions or requirements regarding the number or types of organizations that should be included in a Partnership," and AHRQ will consider many different Partnership models.[viii]

Unlike some of AHRQ's previous RFPs, the prime or lead offeror in the Partnership "may be a not-for-profit or for-profit organization."[ix] The applicant will be the prime or lead organization for this Partnership and may not be a part of any other participating Partnership. Any other member of the Partnership may be associated with multiple applicants.

What are the required activities?

There are 15 enumerated requirements, all of which are designed to ensure that the Partnerships meet the ultimate goals and objectives of ACTION II. Among these requirements are that the research must support AHRQ's priorities that are reflected in its portfolios. Also, the Partnerships must be aware that "AHRQ is particularly interested in . . . how implementation and dissemination of innovations works (or why it does not work)."[x]

What are the stated purposes of ACTION II?

The purposes of ACTION II include increasing the "knowledge about how to put known improvements into routine practice as a key component for improving the quality of care."[xi] Additionally, ACTION II seeks to expand on the research accomplishments obtained through the original ACTION initiative that is scheduled to end on September 30, 2010.

How will ACTION II work?

After receiving the applications in response to the RFP, AHRQ anticipates awarding between 12 and 15 task order master contracts. Throughout the contract period, AHRQ will send out requests for task orders ("RFTO") to these "prime contractors." Within each RFTO, AHRQ will specify research topics targeted by the RFTO, the expected number of awards anticipated, and the cost parameters. Then, the "prime contractors" will have the ability to confer with other members of its partnership and decide whether or not to respond to these RFTOs. These task orders are designed to be completed within short time frames (20 months on average). Each RFTO will require deliverables that "maximize the likelihood that research findings and best practices can and will be appropriately utilized by the intended audience."[xii]

What is the budget?

The minimal total to be awarded is $3,750,000 over the total time period of the initiative (the three-year base period, plus the optional two-year extension period). The maximum funding is anticipated to be $4,500,000 for the three-year base period and $3,000,000 for the optional extension period. Each task order is expected to range from $250,000 to $500,000.

* * *

If you would like additional information regarding this topic, please contact Lynn Shapiro Snyder at 202/861-1806 or,or Daniel G. Gottlieb at 202/861-1881 or dgottlieb@ebglaw.comin the firm's Washington, DC office or the Epstein Becker Green attorney who regularly handles your legal matters. For further information about Epstein Becker Green's Health Care and Life Sciences Practice, or to see back issues of Special Alerts, please visit our Web site at

The Epstein Becker Green Client Alert is published by EBG's Health Care and Life Sciences practice to inform health care organizations of all types about significant new legal developments.

Lynn Shapiro Snyder, Esq.


If you would like to be added to our mailing list or need to update your contact information, please contact, Kristi Swanson, or 202/861-4186.


[i] Request for Proposals, Agency for Healthcare Research and Quality, Accelerating Change and Transformation Organizations and Networks (ACTION II) (Jan. 20, 2010),

[ii] Id.

[iii] Id.

[iv] Id.

[v] Agency for Healthcare Research & Quality, RFP No. AHRQ-10-10005, Accelerating change and transformation in organizations and networks (ACTION II) 9 (Jan. 20, 2010),

[vi] 16.

[vii] Id.

[viii] Id.

[ix] Id. at 17.

[x] 17.

[xi] 10.

[xii] 13.


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