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Tennessee Heart Health Network: Implementing Patient-Centered Practices in Primary Care to Improve Cardiovascular Health

Award Number: U18HS027952
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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Abstract Cardiovascular disease (CVD) is the primary cause of premature morbidity and mortality in the United States. Tennessee ranks 3rd in the U.S. in CVD event rates, 6th in CVD mortality, and 5th in stroke mortality. The state’s high prevalence of CVD is primarily linked to its disproportionate burden of CVD risk factors including obesity, diabetes, and hypertension, and their associated modifiable health behaviors, including poor nutrition, sedentary lifestyle, and tobacco use. Patient-centered medical home initiatives hold some promise for reducing the burden of CVD in Tennessee. But these value-based purchasing endeavors have been insufficient by themselves to support busy primary care practices in implementing patient-centered outcomes research (PCOR) approaches that reach beyond the traditional doctor-patient visit. An insufficient pipeline of primary care providers has made it even more critical to implement team-based care approaches that employ telehealth and lay community health workers to engage patients in better self-care. Yet primary care providers and their team members have little time, knowledge, or resources to identify and implement these proven and financially sustainable PCOR evidence-based population health approaches. The goal of the Tennessee Heart Health Network is to leverage existing infrastructure by identifying and implementing appropriate evidence- based interventions to improve quality and outcomes of CVD care across Tennessee. We will particularly target hypertension control and smoking cessation as two of the most potent CVD risk factors to reduce and/or eliminate disparities in CVD outcomes and risks. We aim to: 1) Establish a statewide Cooperative external quality improvement (QI) support infrastructure, 2) Build a Network of primary care practices and related stakeholders who can utilize the Cooperative as a resource for QI support, 3) Develop a comprehensive, multicomponent, evidence-based approach for a heart health improvement project to improve delivery of PCOR and build internal improvement capacity, 4) Conduct a robust evaluation of all phases of the project, 5) Disseminate interim findings, and 6) Integrate sustainability planning and develop a plan to maintain the Cooperative and its Network of practices and professionals beyond the conclusion of the project. We expect to help primary care practices implement PCOR findings for Tennessee’s priority populations (e.g. African Americans with hypertension and people with obesity, diabetes, and CVD) to transform primary care and measurably improve heart health care and outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	2/22/2024	NON-COMPETING CONTINUATION	$0
2024	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	001	3	9/24/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $1,438,873 )
2023	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP STREET STE 103	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	001	3	2/23/2023	NON-COMPETING CONTINUATION	$1,438,873
2023	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	003	3	8/8/2023	NON-COMPETING CONTINUATION	$0
2023	2022	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	002	2	5/8/2023	NON-COMPETING CONTINUATION	$0
2023	2022	UNIVERSITY OF TENNESSEE	62 S DUNLAP STREET STE 103	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	11/30/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,438,873

Issue Date FY: 2022 ( Subtotal = $1,449,185 )
2022	2022	UNIVERSITY OF TENNESSEE	62 S DUNLAP STREET STE 103	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	001	2	2/22/2022	NON-COMPETING CONTINUATION	$1,449,185
2022	2021	UNIVERSITY OF TENNESSEE	62 S DUNLAP STREET STE 103	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	2/1/2022	NEW	$0
														Subtotal = $1,449,185

Issue Date FY: 2021 ( Subtotal = $1,519,716 )
2021	2021	UNIVERSITY OF TENNESSEE	62 S DUNLAP STREET STE 103	MEMPHIS	TN	38103	SHELBY	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	3/1/2021	NEW	$1,519,716
														Subtotal = $1,519,716

Grand Total All Awards = $4,407,774

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Tennessee Heart Health Network: Implementing Patient-Centered Practices in Primary Care to Improve Cardiovascular Health

Award Number: U18HS027952

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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