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FY 2006 Budget in BriefAgency for Healthcare Research and QualityOn this page:
The Agency for Healthcare Research and Quality promotes health care quality improvement by conducting and supporting health services research that develops and presents scientific evidence regarding all aspects of health care. The FY 2006 request for the Agency for Healthcare Research and Quality (AHRQ) provides a total program level of $319 million, the same as FY 2005. Priority activities include continued efforts to improve patient safety through the implementation of proven information technologies, and new comparative effectiveness research anticipated by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). AHRQ conducts and sponsors health services research to inform decision-making and improve clinical care and the organization and financing of health care. AHRQ evaluates both clinical services and the system in which these services are provided. This work contributes not only to improved clinical care, but also to more cost-effective care. AHRQ supports the translation of research into measurable improvements in the care Americans receive. AHRQ has forged cooperative relationships with major health care organizations to ensure that research funded by the agency is implemented by the major players in the health system. The agency's research agenda is broad and spans from medical informatics to long-term care; from pharmaceutical outcomes to prevention to responses to bioterrorism. Five Steps to Safer Health Care
Excerpts from Five Steps to Safer Health Care. Patient Fact Sheet. July 2003. AHRQ Publication No 03-M007. Agency for Healthcare Research and Quality, Rockville, MD. www.ahrq.gov/consumer/5steps.htm Health Costs, Quality, and OutcomesThe President's Budget will continue to support improvements through research on the cost effectiveness and quality of health care by providing a total of $261 million. This total includes $84 million for Patient Safety and $15 million for comparative effectiveness research authorized by the MMA. Patient Safety: The patient safety research portfolio for AHRQ was dramatically expanded in FY 2001 in response to the Instititute of Medicine's report, To Err Is Human. In FY 2004, AHRQ redirected much of its patient safety funding to accelerate the adoption of health information technologies that are proven to reduce medical errors and, by doing so, reduce the cost of health care. In FY 2005 and FY 2006, AHRQ will continue to direct $50 million of its patient safety resources to information technology investments designed to enhance patient safety, with an emphasis on small community and rural hospitals/health care systems. These investments will encourage uptake of technologies such as computerized physician order entry, computer monitoring for potential adverse drug events, automated medication dispensing, computerized reminder systems to improve compliance with guidelines, handheld devices for prescription information, computerized patient records, and patient-centered computerized support groups. The first awards for implementation of these technologies were made in summer 2004. AHRQ grants provided up to 50 percent of the total project costs, with a maximum of $500,000 per year per project. Working with public and private partners, AHRQ will use data from Hospital Information Technology investment demonstrations to make the business case for adoption of these tools, and help spread proven technology through the healthcare system. AHRQ's FY 2004 plan laid the groundwork for the challenge the President has issued to the health care system to enable the majority of Americans to be able to benefit from secure electronic health records within ten years. Outside AHRQ, the FY 2006 request includes a new $75 million account in the Office of the National Coordinator for Health Information Technology (ONCHIT) to finance targeted activities needed to bring together the health care providers in each region to adopt standards-based, interoperable Electronic Health Records systems. Reaching the President's ten-year goal requires initiating, in FY 2005, regional collaborations to assist health care providers in the deployment of interoperable applications. As a result, AHRQ has decided to direct $14 million in FY 2005 to jump-start these collaborations in a number of regions, with funds derived from a combination of an internal reallocation of $11.5 million into patient safety and an additional $2.5 million provided by the Secretary's authority to transfer limited amounts between agencies. This additional investment will enhance existing and future efforts in pharmaceutical outcomes, comparative effectiveness, and improved care delivery. In FY 2006, continuation of these collaborations will be provided through the new ONCHIT account. 10 Priority Conditions for Comparative Effectiveness Research
AHRQ will continue to invest $10 million on the development of clinical terminology, messaging standards, and other tools needed to accelerate the use of cost-effective healthcare information technology. AHRQ will fund research to identify barriers and practical solutions to the development and use of health information systems to support quality improvements and patient safety, since one major obstacle is the lack of clinical terminology and messaging standards that support interoperability. These priority projects will support patient safety in the U.S., develop a common vision for health information technology and standards across the health care spectrum, and promote and accelerate efforts needed to make that vision a reality in the U.S. The remaining $24 million in AHRQ's patient safety budget supports a variety of activities. AHRQ will continue to work collaboratively with the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare & Medicaid Services, to develop a common Web interface for medical providers that will both enhance the usefulness of adverse event information and reduce the reporting burden for their partners in the health care community. Comparative Effectiveness Research: In FY 2006, AHRQ will continue a $15 million research portfolio to develop state-of-the-art information about the effectiveness of interventions, including prescription drugs, for ten top conditions affecting Medicare beneficiaries. This work, authorized by section 1013 of the MMA, is being initiated in FY 2005. This new initiative is focused solely on conditions that are common and costly among those whose health care is funded by Medicare, Medicaid, and the State Children's Health Insurance Program. The list of priority conditions was developed with substantial input from the public and stakeholders; HHS used both public listening sessions and systems for receipt of written comments similar to that used to solicit public comments on regulatory changes under consideration. This research will take the form of systematic reviews and syntheses of the scientific literature. Researchers will focus on the evidence of outcomes, comparative clinical effectiveness and the appropriateness of use of pharmaceuticals, health care services, and other health care items. Research and Dissemination Activities Outside Patient Safety:In FY 2006, AHRQ will invest $162 million in research and dissemination activities in prevention, pharmaceutical outcomes, informatics, and other areas to support the quality and cost-effectiveness of health care. A number of AHRQ efforts are oriented toward making research findings accessible. For example, in the CERTs program, studies have been underway to gather information that Medicaid programs can use to make coverage and other policy decisions such as drug utilization review, economic effects of beta- blocker therapy in heart failure, and prevalence of type 2 diabetes mellitus in children. Under its Evidence-based Practice Program, AHRQ is developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. For example, one of AHRQ's Evidence-based Practice Centers (EPC) recently issued a report on the effectiveness of laser treatment and vacuum-assisted closure on wound healing; this research had been requested by the American Association of Health Plans. AHRQ will continue to sponsor the U.S. Preventive Services Task Force. The USPSTF has issued clinical recommendations on colorectal cancer, breast cancer, osteoporosis, hormone replacement therapy, depression, and aspirin chemoprevention for patients at risk for heart disease. Medical Expenditure Panel SurveysThe FY 2006 budget for Medical Expenditure Panel Surveys (MEPS) includes a request for $55 million, the same as FY 2005. MEPS is the collection of detailed, national data on the health care services Americans use, how much they cost, and who pays for them. It is the only national source of visit-level information on medical expenditures. MEPS provides a better understanding of the quality of care the typical patient receives, and of disparities in the care delivered. MEPS data are critical for tracking the impact of Federal and State programs, including the State Children's Health Insurance Program (SCHIP), Medicare and Medicaid. These surveys also provide a substantial portion of the data used to develop two reports, required by the agency's 1999 reauthorization, that seek to measure the quality of health care in America and differences in access to health care services for priority populations. The National Healthcare Quality Report includes information on patient assessment of health care quality, clinical quality measures of common health care services, and performance measures related to outcomes of acute and chronic disease. The second report - the National Healthcare Disparities Report - highlights populations that are at high risk for differences in care. These populations include the elderly, people in inner-city and rural areas, women, children, minorities, low-income groups, and individuals with special health care needs. AHRQ used a formal notice and comment process to solicit public comments on the measures that should be included in the upcoming 2005 report. The current editions of both reports are available on a new Web site, www.qualitytools.ahrq.gov. In addition, the site serves as a Web-based clearinghouse by providing information for health care providers, health plans, policymakers, purchasers, patients and consumers to take effective steps to improve quality. In FY 2006, AHRQ will be fully funded through inter-agency transfers of evaluation funds. |
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Last revised: March 31, 2005
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