FY 2005: Research on Health Costs, Quality and Outcomes (HCQO) (continued)

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Rationale for AHRQ's FY 2005 Request

The FY 2005 request maintains the FY 2004 enacted level for the Research on HCQO budget activity. These components are:

Component	Amount         Increase/Decrease
1. Research and Training Grants	$14,855,000
(Non-Competing Patient Safety Grants)	(+ $30,052,000)
(Non-Competing Non-Patient Safety Grants)	(- $24,711,000)
(New Patient Safety Research and Training Grants)	(- $31,000,000)
(New Non-Patient Safety Research and Training Grants)	(+ $10,953,000)
(Non-Patient Safety Supplements)	(- $149,000)
2. Non-MEPS Research Contracts and IAAs	+ $12,955,000
(Patient Safety Contracts and IAAs)	(+ $5,448,000)
(Non-Patient Safety Contracts and IAAs)	(+ $7,507,000)
3. Research Management	+ $1,900,000

The budget continues the President's commitment to improve the quality of care and patient safety in all health care setting by proposing $84,000,000, $4,500,000 above the FY 2004 level, in AHRQ. Within this total, $50,000,000 will fund grants to continue efforts to promote, accelerate, and demonstrate the development and adoption of information technology, including small and rural communities where health information technology penetration has been low.

The President's budget proposes doubling to $100,000,000 funding for demonstration projects on promising health care information technology (IT). In support of this effort, the budget proposes $50,000,000 in new funding within the Office of the Secretary to support State or regional demonstration grants to test the feasibility of information technology exchange among health care settings and to fund other innovative IT projects that improve health care quality. These investments will complement and build upon AHRQ's FY 2004 demonstration grants and other activities to evaluate the effects of IT on the safety and quality of health care, a critical component of assuring that the IT's positive benefits are adopted broadly.

These efforts will also help to accelerate public-private efforts to adopt health data standards begun under the President's Consolidated Health Informatics initiative, to set uniform standards for the exchange of clinical health information within the Federal government. In 2003, standards in 5 of 24 health data domains were endorsed, addressing areas such as laboratory test results and retail pharmacy transactions.

The Administration will work with those involved in health care IT to advance the effort to translate IT opportunities into higher quality, safer and more efficient health care for all Americans.

Research and Training Grants (-$14,855,000)

The FY 2005 request provides a decrease of $14,855,000 for research and training grants over the FY 2004 enacted level of $113,770,000.

Non-Competing Research and Training Grants (+$5,341,000)

Patient Safety

The FY 2005 the non-competing research and training grants portion of the patient safety portfolio are funded at $40,491,000, an increase of $30,052,000. This includes a total of $31,000,000 to continue commitments for the FY 2004 Patient Safety Health Care Information Technology Program.

Non-Patient Safety

The FY 2005 non-competing non-patient safety research and training grants are continued at $34,971,000, a decrease of $24,711,000 from the FY 2004 enacted level of $59,682,000. This decrease in non-competing funds allows AHRQ to fund new non-patient safety research in the FY 2005 Request.

Performance Goals for Non-competing Research and Training Grants AHRQ's non-competing research and training grants are directly linked to three of our strategic outcome goals. AHRQ Goal 1. Safety/Quality. Improve health care safety for all Americans through evidence-based research and translation and to build capacity to improve the quality of health care for Americans. AHRQ Goal 2. Efficiency. Develop strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. AHRQ Goal 3. Effectiveness. Translate, disseminate, and implement research findings that improve health care outcomes. Each specific grant is then further divided into 1 of 11 portfolios of work. Each portfolio of work also has outcome and output goals. For details, go to the the section on goals by portfolio of work.

New Research and Training Grants (-$20,196,000)

Patient Safety (-$31,000,000)

AHRQ's initial investment in Health Care Information Technology (HIT) in FY 2004 supported the development of new knowledge and best practices regarding diffusion of HIT in health care settings. As we strive to achieve widespread implementation of HIT to improve patient safety and quality, we have much to learn about the transition from planning for HIT in a community to implementation. As part of AHRQ's Transforming Healthcare Quality through Information Technology (THQIT) research funding, $7,000,000 was invested in 1-year planning grants in FY 2004, with $5,000,000 directed to small and rural communities. At the end of the planning year, AHRQ expects that many of these small and rural communities will be ready to launch interoperable implementation projects in their community. For us to learn generalizable lessons from the diffusion of HIT in these communities, AHRQ proposes to reinvest the $7,000,000 in FY 2005 for new implementation awards for those communities that have completed a successful planning process. The main objective of these new implementation awards would be to support organizational and community-wide implementation of HIT as well as to evaluate the extent to which HIT contributes to measurable and sustainable improvements in patient safety, cost, and overall quality of care. Local and regional collaborations within small and rural communities, acute care hospitals, community health centers, public health departments will be targeted.

Non-Patient Safety (+$10,804,000)

In the FY 2005 request, AHRQ's new non-patient safety research and training grants increase $10,804,000 from the FY 2004 enacted level of $5,649,000. By reinvesting funds from non-competing grants, AHRQ requests $14,039,000 to renew several AHRQ programs, including:

• Small research grants, conference grants, dissertation grants, grant supplements, research career awards.
• The Building Research Infrastructure & Capacity Program (BRIC) program.
• Minority Research Infrastructure Support Program (M-RISP).
• Centers for Education and Research on Therapeutics (CERTs) program.
• Practice Based Research Networks (PBRNs).

In addition, AHRQ requests $2,414,000 in new funds for Research Empowering America's Changing Healthcare System (REACHES). These funds will expand work in the area of adopting research findings in real-world settings and assessing their impact and generalizability.

Small Research Grants (+$1,700,000). In FY 2005, AHRQ requests $1,700,000 to support small research grants. AHRQ's small research grant program is designed to provide support for new investigators or researchers new to health care services issues. These grants encourage preliminary, exploratory, or innovative research in new or previously unexamined areas. Some of AHRQ's currently funded small research grants include:

• Racial Difference in Physician-Patient Communication (University of Rochester).
• Uncertainty in Cost Effectiveness Analysis (Columbia University of Health Sciences).
• Nursing Practice Models in Long-term Care Facilities (University of Minnesota).
• The Experiences and Challenges of Informal Caregivers (Johns Hopkins University).
• Do False Mammograms Lead to Negatively Affected Health? (Medical College of Wisconsin).

Conference Research Grants (+$1,439,000). In FY 2005, AHRQ requests $1,439,000 to fund conference research grants. Conference grants are intended to complement and promote AHRQ's core research by providing a mechanism to:

• Develop health services research agendas and identify strategies and mechanisms for studying them.
• Discuss and develop consensus around health services research methodological and technical issues.
• Disseminate health services research information and facilitate adoption of research findings from AHRQ-sponsored research and research training grants in the formulation or evaluation of health policy, management of health care programs, and use or purchase of health services.
• Develop partnerships with stakeholder organizations and build their capacity to participate in research activities and use the results of health services research.

Dissertation Research Grants (+$500,000). In FY 2005, AHRQ requests $500,000 to support dissertation grants. Through the Dissertation Research Grant Program, AHRQ seeks to expand the number of researchers who conduct health services research related to AHRQ's mission and strategic plan. Funding is available for students conducting doctoral-level research on some aspect of the health care system. These grant awards are often the first step in a health services research career. Some of AHRQ's currently funded small research grants include:

• Nursing Interventions and Outcomes Post Prostatectomy (University of Pennsylvania).
• Telehealth Support in Cardiovascular Disease (University of Connecticut).
• Modeling Health Utilization of Medicaid Children (Georgia State University).
• Understanding the Role of Race in Physician Decision to Prescribe Opioid Analgesia (Metrohealth Medical Center).

Supplements (+$500,000). AHRQ requests $500,000 for grants supplements in FY 2005. AHRQ makes supplemental grants funds for three purposes:

• Administrative supplements, which are made only when the need for additional funds is due to unforeseen costs to fulfill objectives of the grant project or to expand the scope of a grant project.
• Supplements to a principle investigator who employs minority investigators.
• Supplements to a principle investigator who employs investigators with disabilities.

In FY 2001, AHRQ used administrative supplements to increase funding for the CERTs program. AHRQ recognized that the mission of the CERTs was consistent with the patient safety agenda and therefore provided additional funding to enhance the work of the CERTs in this area.

Research Career Awards (+$2,500,000). In FY 2005, AHRQ requests $2,500,000 to support Research Career Awards. Research Career Awards provide individuals time and resources to gain experience in carrying out actual research. The intent is to provide transitional support for newly trained investigators in order to launch them on research careers. AHRQ supports two types of career awards:

• Independent Scientist Award (K02) in Health Services Research. The K02 provides support for newly independent investigators with a clinical or research doctoral degree to enable them to develop their research careers. Examples of recently funded K02 awards include:
  • Health Communication Over the Internet (University of Texas, Houston).
  • Two-Stage Model for Colorectal Cancer Screening (Baylor College of Medicine).
  • Improving Dispute Resolution in Healthcare (Harvard University).
• Mentored Clinical Scientist Development Award (K08) in Health Services Research. The K08 provides support for the development of outstanding clinician research scientists who are committed to a career in health services research, with a focus on development as an independent scientist. Examples of recently funded K08 awards include:
  • Emergency Department Crowding: Cause and Consequences (Health Partners Research Foundation, Minneapolis).
  • Clinical Prediction Rule for Pelvic Fracture Hemorrage (University of Washington).
  • Collaborative Management of Diabetes in Blacks (Medical University of South Carolina).

Building Research Infrastructure & Capacity Program (BRIC) (+$1,000,000).

In FY 2005, AHRQ requests $1,000,000 to renew the Building Research Infrastructure & Capacity Program (BRIC) program. BRIC was launched by AHRQ in FY 2001 to build research capacity in States that have not traditionally been involved in health service research. The primary goals of BRIC are to:

• Enhance the competitiveness of research institutions and organizations in the BRIC eligible States for AHRQ-funded grants.
• Increase the probability of long-term growth of AHRQ-competitive funding to investigators at institutions from these eligible States.

AHRQ funded six BRIC awards in FY 2001. Ten States received direct funding with collaborations spanning across the country. For example, in the Intermountain Region where rural and frontier health care issues are a major concern, five States have formed a consortium and are sharing resources to develop individual state projects that will be submit to AHRQ as future research projects. In Mississippi where health care for children living in the Delta is poor or nonexistent, the BRIC grantee has formed partnerships with several pediatric experts, including consultants from Harvard. These grants ended in FY 2002. Renewal of this program in FY 2005 will allow AHRQ to build, increase, strengthen, and sustain the health services research competitiveness of institutions and organizations within eligible states.

Minority Research Infrastructure Support Program (M-RISP) (+$1,000,000). In FY 2005, AHRQ requests $1,000,000 in new funds for two additional Minority Research Infrastructure Support Program (M-RISP) grants, for total support of $2,000,000 in FY 2005. The M-RISP program was established to increase the capacity of institutions that serve racial and ethnic minorities to conduct rigorous health services research. In FY 2001, the first year of the program, three educational institutions located in Hawaii, Tennessee and Texas were funded. In FY 2002, two more institutions in North Carolina and Washington, D.C. received support. In addition to complementing the Agency's goal of building capacity and infrastructure to conduct health services research in predominantly minority institutions, the research supported under these grants focus on the Departmental priorities of reducing racial disparities and improving health for priority populations. The FY 2001 projects will expire in FY 2003. The projects begun in FY 2002 will receive continuation funding. New funds in FY 2005 will allow AHRQ to develop and broaden the national infrastructure for conducting health services research.

Non-Patient Safety CERTs (+$3,400,000). In FY 2005, AHRQ requests $3,400,000 in new funds to support four CERTs grants. AHRQ is currently supporting eight CERTs for a total of $5.1 million. Total support for CERTs in FY 2005 would be $8.5 million.

CERTs is a national effort to increase awareness of the benefits and risks of new, existing, or combined uses of therapeutics, such as pharmaceuticals, through education and research. The program, which currently consists of seven centers and a Coordinating Center, is administered as a cooperative agreement by AHRQ, in consultation with the FDA. The research conducted by the CERTs program has three major aims:

• To increase awareness of both the uses and risks of new drugs and drug combinations, biological products, and devices as well as of mechanisms to improve their safe and effective use.
• To provide clinical information to patients and consumers; health care providers; pharmacists, pharmacy benefit managers, and purchasers; HMOs and health care delivery systems; insurers; and government agencies.
• To improve quality while reducing cost of care by increasing the appropriate use of drugs, biological products, and devices and by preventing their adverse effects and consequences of these effects (such as unnecessary hospitalizations).

The centers have completed several important projects since their inception. Researchers at the University of North Carolina center published a study showing a link between rickets in breast-fed children and a lack of vitamin D supplementation, especially among black infants. As a result of this study, the North Carolina Department of Health and Human Services made vitamin D available free to breast-feeding women through its Women, Infants, and Children (WIC) program. In another study, researchers at the Duke University center examined trends in aspirin use, patient characteristics, and long-term outcomes for aspirin effectiveness in more than 25,000 patients with cardiovascular diseases. They found that the percentage of patients with heart disease who report taking aspirin regularly increased between 1995 and 1999.

The CERTs concept grew out of recognition that, while pharmaceuticals and other medical products improve the lives of many patients, underuse, overuse, adverse events, and medical errors may cause serious impairment to patient health. Additional support for the CERTs program will ensure research on the knowledge gaps that remain:

• Limited comparative information exists on the risks, benefits, and interactions of both new and older agents.
• Lack of guidance to health professionals on the appropriate, cost-effective use of therapeutics that will, in turn, lead to improved outcomes, error reduction, and prevention of adverse events.

Practice Based Research Networks (PBRNs) (+$2,000,000). In FY 2005, AHRQ requests $2,000,000 to renew the Practice Based Research Networks (PBRNs). All of AHRQ's PBRNs expire in FY 2003. PBRNs are groups of community-based practices that work together with clinical investigators to study questions related to primary care and to assure that evidence-based findings are incorporated into actual practice.

With current levels of funding, AHRQ has been able to support 40 networks nationwide. These networks include around 10,000 primary care providers (pediatricians, family physicians, general internists, and nurse practitioners) in community-based practices located in rural, suburban and inner-city settings in all 50 States. These clinicians provide care to around 10 million Americans, including those insured by Medicare, Medicaid, and those who are uninsured. AHRQ has recently begun collaborating with the Robert Wood Johnson Foundation on a PBRN-focused activity to promote healthy behaviors, including increased physical activity and improved diet. AHRQ's request of $2,000,000 for this program will improve the capacity of PBRNs to expand the primary-care knowledge base and to establish mechanisms to assure that new knowledge is incorporated into actual practice.

Research Empowering America's Changing Healthcare System (REACHES) (+$2,414,000). In FY 2005, AHRQ requests $2,414,000 in new funds to expand work in the area of adopting research findings in real-world settings and assessing their impact and generalizability. AHRQ's model of the full research cycle is shown in Figure 3 (7 KB). Historically, most health services research has focused on the Discovery and Dissemination phases of research, with the ultimate goal being publication in a peer-reviewed journal. This grant program will focus on Adoption and Assessment, and will fund demonstration projects for translating existing research into clinical practice, the management of health care organizations, and influence health policy.

REACHES will provide funding for such demonstration projects, including assessments of their effectiveness, and funding for the design and testing of strategies for the wide-spread adoption and utilization of research results that support achieving AHRQ's portfolio outcomes. REACHES builds on AHRQ's prior investments in the Translating Research Into Practice program.

Performance Goals for New Research and Training Grants AHRQ's new research and training grants are directly linked to three of our strategic outcome goals. AHRQ Goal 1. Safety/Quality. Improve health care safety for all Americans through evidence-based research and translation and to build capacity to improve the quality of health care for Americans. AHRQ Goal 2. Efficiency. Develop strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. AHRQ Goal 3. Effectiveness. Translate, disseminate, and implement research findings that improve health care outcomes. Each specific grant is then further divided into one of 11 portfolios of work. In the case of small grants, conference grants, grant supplements, PBRNs, and Research Career Awards, and REACHES until the actual award has been made, we are unable to provide a portfolio of work. At the time of funding, AHRQ will conduct gap analysis of our current 11 portfolios of work and will fund those grants with high peer review scores that also "fill the gap." For details, go to the section which provides goals by portfolio of work. Dissertation grants, the BRIC program and the M-RISP program will follow the overall outcome and output goals associated with the training portfolio for FY 2005. New funds for the CERTs program will follow the overall outcome and output goals associated with the Pharmaceutical portfolio.

Non-MEPS Research Contracts and IAAs (+$12,955,000)

The FY 2005 request provides an increase of $12,955,000 for contracts and IAAs over the FY 2004 enacted level of $82,625,000.

Patient Safety Contracts and IAAs (+$5,448,000)

The FY 2005 request for patient safety contracts and IAAs reflects an increase of $5,448,000 from the FY 2004 enacted level of $31,061,000. With this increase, AHRQ will fund $3,688,000 in continuing patient safety contracts reduced or not funded in FY 2004, including support for the patient safety Integrated Delivery Systems Research Networks and the patient safety user liaison program.

Included in the FY 2005 request is $1,800,000 in new IAAs for an ambulatory information technology demonstration focused on the Indian Health Service (IHS). These funds will help refine and expand the IT infrastructure within the Indian health system to improve health status monitoring, health care quality and efficiency, and financial management of IHS. At the same time, it will produce open source products and generalizable knowledge from the implementation process to share with a broader audience, such as community health center clinics.

Performance Goals for Patient Safety Contracts and IAAs AHRQ's patient safety contracts and IAAs are directly linked to three of our strategic outcome goals. AHRQ Goal 1. Safety/Quality. Improve health care safety for all Americans through evidence-based research and translation and to build capacity to improve the quality of health care for Americans. AHRQ Goal 2. Efficiency. Develop strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. AHRQ Goal 3. Effectiveness. Translate, disseminate, and implement research findings that improve health care outcomes. Patient safety contracts and IAAs will follow the overall outcome and output goals associated with the quality/safety of patient care portfolio for FY 2005.

Non-Patient Safety Contracts and IAAs (+$7,507,000)

The FY 2005 request for non-patient safety contracts and IAAs is increased by $7,507,000 from the FY 2004 enacted level of $51,564,000. These funds will be directed to both continuing and new non-patient safety contracts. AHRQ requests $3,560,000 to continue enduring AHRQ programs. AHRQ also requests $3,947,000 in new contracts focusing on implementing new research to close the gaps in AHRQ's research portfolios.

Continuing Contracts (+$3,560,000). AHRQ is requesting an increase of $3,560,000 over the FY 2004 enacted level to continue enduring research contracts. The following research contracts are requesting increases from the FY 2004 enacted level to the FY 2005 request.

Evidence-based Practice Centers. In FY 2005, $4,400,000 is requested to fund a variety of Evidence-based Practice Centers (EPCs). Since the Agency established the EPC Program in 1997, the availability of EPC clinical and methodological expertise has become a magnet to an increasing number and variety of professional societies, providers, payers, and policymakers. The EPC's are jointly funded by AHRQ and the organizations that recommended the research and have committed to using it. The EPC portfolio has expanded from solely clinical topics to topics ranging from clinical and behavioral health, to health policy, to special economic studies. For example, the 13 EPCs are providing systematic review and analyses in evidence reports for professional societies, providers and other private sector entities that focus on established clinical care practices, as well as alternative and preventive health care practices. Further, EPC reports are focusing on:

• Economic studies (e.g., Utilization of Physician Services).
• The effectiveness of financial incentives to patients and providers to enhance the delivery of clinical preventive services.
• Cost studies, such as the burden of illness/economic consequences of occupational asthma.

Beginning in FY 2002, the EPCs moved more fully into the health policy arena as providers and purchasers demanded that the EPC expertise also be channeled into production of evidence-based information to help in the decisionmaking for purchasing quality health care for their employees. In AHRQ's reauthorization legislation, the Congress directed the Agency to provide widespread guidance on systems or methods to rate the strength of scientific evidence. As a first step in developing such guidance, AHRQ commissioned the EPC report "Systems to Rate the Strength of Scientific Evidence." This important report is an essential teaching tool not only for researchers but for purchasers and providers—educating on how to assess the scientific strength or credibility of health care studies.

The EPCs also review and summarize evidence relevant to Departmental priorities such as validation of tools to improve quality of care for hospitalized Medicare beneficiaries. Improvement in the quality and effectiveness of health care can occur only through establishing the evidence for such care and translating that evidence into practical tools that are easily understood and used by the many and varied sectors involved in health care.

National Guideline Clearinghouse™ (NGC). In FY 2005, $1,300,000 is requested to fund the NGC. NGC, an Internet resource for evidence-based clinical practice guidelines located at www.guideline.gov, has been operational for 6 years. The NGC was develop by AHRQ in partnership with the American Medical Association (AMA) and the American Association of Health Plans (AAHP) to be a resource for physicians, nurses, educators, and other health care professionals.

The NGC is designed to promote quality health care by making the latest evidence-based clinical practice guidelines available in one easy-to-access location. The NGC Web site is updated weekly with new and revised guidelines. In addition to its 24-hour access on the Internet, the clearinghouse has many useful features such as standardized abstracts containing information about each guideline and how it was developed, the ability to make guideline comparisons, access to the full text of guidelines or ordering information, and the capability to browse for guideline titles by organization, disease/condition, or treatment/intervention.

Undoubtedly, the NGC's capacity to make vast amounts of information quickly accessible to clinicians is its biggest asset. Before the development of the NGC, clinicians and others who wanted to study or compare guidelines for any medical condition had to contact individual guideline developers to obtain a copy. Users then had to perform their own side-by-side analysis to determine which, if any, of the guidelines they wanted to follow. The usefulness of the NGC is evidenced by the large number of visits every week by physicians and other health professionals.

National Quality Measures Clearinghouse™ (NQMC). In FY 2005, $3,000,000 is requested to fund the NQMC. NQMC is a Web-based repository of tools for measuring health care quality located at www.qualitymeasures.ahrq.gov. The NQMC mission is to provide practitioners, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining detailed information on quality measures, and to further their dissemination, implementation, and use in order to inform health care decisions.

The site is designed to be a one-stop shop for physicians, hospitals, health plans, and others who may be interested in quality measures. Users can search the NQMC for measures that target a particular disease/condition, treatment/intervention, age range, gender, vulnerable population, setting of care, or contributing organization. Visitors also can compare attributes of two or more quality measures side by side to determine which measures best suit their needs. The site also provides material on how to select, use, apply, and interpret a measure.

The NQMC builds on AHRQ's previous activities in quality measurement and will be part of a larger Web site of quality, clinical information, and decision tool components that will include the National Guideline Clearinghouse™ at www.guideline.gov. The NQMC and NGC will be linked for those who wish to coordinate their search for both quality measures and guidelines.

New Contract—Research Empowering America's Changing Healthcare System (REACHES) (+$3,947,000). AHRQ is requesting $3,947,000 to develop new contracts designed to further the adoption of research findings into real-world practice and assessment of their impact in our main portfolio areas. Historically, most health services research has focused on the Discovery and Dissemination phases of research, with the ultimate goal being publication in a peer-reviewed journal (see Figure 3, 7 KB). This contract will focus on Adoption and Assessment. In the past, AHRQ's work on Translating Research Into Practice has sponsored grants for applied research to develop sustainable and replicable models and tools to improve the quality, outcomes, effectiveness, efficiency and cost effectiveness of health care and widely disseminating the results of that research. In contrast, the proposed activities will:

• Help identify tools and bodies of research within AHRQ's portfolios that are ready for wide-spread adoption and assessment to improve health and health care and achieve measurable outcomes (this includes the Health Plan Learning Collaborative program, designed to assist health plans in reducing disparities in care and outcomes).
• Identify areas within the portfolios where additional research is needed in order to be ready for adoption.
• Summarize existing research into adoption-amenable formats;
• Assess the extent to which existing efforts to synthesize complex information and make research-based recommendations (including best practices) have been adopted, and develop plans to further their wide-spread adoption and assess the impact on quality and disparities in care;
• Identify and summarize what is known about methods for encouraging the wide-spread adoption of research findings in order to improve health and health care and achieve measurable outcomes, including what individual practitioners (e.g., physicians, hospital administrators, health plan administrators, policymakers) regard as adequate evidence for changing their practice, and the methods, formats, and partners through which they would like to receive such information.

REACHES will emphasize the areas identified as opportunities for improvement in the National Healthcare Quality Report and the National Healthcare Disparities Report.

Performance Goals for General Non-Patient Safety Contracts and IAAs AHRQ's non-patient safety contracts and IAAs are directly linked to three of our strategic outcome goals. AHRQ Goal 1. Safety/Quality. Improve health care safety for all Americans through evidence-based research and translation and to build capacity to improve the quality of health care for Americans. AHRQ Goal 2. Efficiency. Develop strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. AHRQ Goal 3. Effectiveness. Translate, disseminate, and implement research findings that improve health care outcomes. Each specific contract and IAA is then further divided into one of 11 portfolios of work. Each portfolio of work also has outcome and output goals. For details, go to the section which provides goals by portfolio of work.

Research Management (+$1,900,000)

In FY 2005, AHRQ requests an increase of $1,900,000 for research management costs. These funds will provide for current services, including amortization of the FY 2004 pay raise, the FY 2005 pay raise, and inflation. This Request includes $907,000 to support the Unified Financial Management System (UFMS). The UFMS will be implemented to replace five legacy accounting systems currently used across the Operating Divisions.

Performance Goals for Research Management AHRQ's research management goals are directly linked the following strategic outcome goals. AHRQ Goal 4. Organizational Excellence. Develop efficient and responsive business processes. Organizational Excellence Portfolio Budget & Performance Integration FY Targets Actual Performance Reference FY 2005 Planning System—Implement additional phases. Conduct followup reviews of the PARTs.

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Internet Citation:

Research on Health Care Costs, Quality and Outcomes (HCQO). From: Justification for Budget Estimates for Appropriations Committees, Fiscal Year 2005, February 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/cj2005/hcqo05a.htm

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