ARPA-H announces new program to kick-start investment in preventive care

The Advanced Research Projects Agency for Health is seeking proposals to encourage investment in preventive care — especially in areas of the country where health outcomes are worse than the national average.

Financial incentives are a key part of the Health Care Rewards to Achieve Improved Outcomes, or HEROES program, according to ARPA-H Director Renee Wegrzyn.

The goal is to kick-start a virtuous cycle, where health organizations and their partners invest money in addressing critical and preventable health problems and are compensated if their efforts are successful.

“What if actually investing in prevention was not only the right thing to do, but it was also the smart thing to do if you’re a business?” said Dr. Darshak Sanghavi, HEROES program manager.

How it works: ARPA-H’s forthcoming request for pitches seeks proposals from what it’s calling “health accelerators,” such as community health centers, health provider systems, nonprofits, payers or combinations of groups working together.

That organization or group will target a geographic region, anywhere from around half a million to 5 million people, and choose one of four health issues to work on: maternal health complications, opioid overdoses, heart attack and stroke risk or alcohol-related harms.

Once awarded a contract, they’ll go to work on a “pay for success” basis.

Sanghavi stressed that these are public-private partnerships. While ARPA-H will commit up to $15 million toward achieving certain health outcomes, they are giving preference to parts of the country that secure matching funds from entities such as large employers, payers or philanthropies.

If the organization is seeking to reduce obstetric complications in its region and improves the rate of complications over time, ARPA-H and investors will pay them for that success.

“When the ARPA-H training wheels come off after several years, the program becomes sustainable over time,” Sanghavi said.

Why it matters: Social determinants of health, like access to health care, education and neighborhood quality, are strong predictors of people’s health outcomes.

“We have a life expectancy which lags many other nations, we have rates of chronic disease which are higher than they should be, and we suffer from persistent disparities in outcomes in a variety of areas,” Sanghavi said.

Americans in rural areas die at higher rates than those in urban areas, and people with low incomes die 15 years younger than the highest earners, according to ARPA-H. Those different outcomes are due in part to differences in access to health care.

“When you look at the geographic areas, we still don’t have the right incentives and the right accountability for prevention. That’s what the HEROES program seeks to actually improve.”

What’s next? ARPA-H wants feedback from health groups and investors interested in the HEROES program to determine whether any changes to it need to be made.

A Proposer’s Day is slated for Feb. 13-14 in Washington to learn about the program and share feedback before the final solicitation for proposals in the early spring.

“This is a complicated program. We want to get it right,” Sanghavi said.