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FY 2007 Budget in BriefAgency for Healthcare Research and QualityOn this page:
Agency for Healthcare Research and QualityThe 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 2007 request for the Agency for Healthcare Research and Quality (AHRQ) provides a total program level of $319 million, the same as FY 2006. Priority activities include continued efforts to improve patient safety through the implementation of proven information technologies. 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 and from pharmaceutical outcomes to prevention. 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 for these activities. This total includes $84 million for Patient Safety and $15 million for the Effective Health Care Program authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). Patient Safety: Of the total $84 million for patient safety, $50 million will be made available for health information technology (IT) investments designed to enhance patient safety, with an emphasis on ambulatory patient care. AHRQ's significant investment in hospital safety has demonstrated the importance of patient safety reporting systems, computerized physician order entry, and decision support systems to key stakeholders and policymakers. While the use of hospital-based IT for patient safety has been rising, an adoption gap exists in ambulatory care, especially in smaller practices with five or fewer doctors, where 60 percent of physicians continue to practice. AHRQ Within the budget for health IT, AHRQ will provide $29 million for the Ambulatory Patient Safety Program with an additional $6 million in general Patient Safety funds. This program has a five-year goal of measurably improving the safety and quality of care for patients in ambulatory environments using health IT. It will complement and contribute to the overall goals and objectives of the President's health IT initiative, the American Health Information Community, and those of the Office of the National Coordinator for Health Information Technology (ONC). AHRQ will examine the best ways to develop, deploy, and evaluate the use of electronic health information systems, both the technology and the processes around it - by addressing systemic barriers to adoption and creating the evidence base for best practices. The program will focus on four cross-cutting care domains to achieve the goal of improvements in: medication safety, patient-centered care, medication management, and integration of decisions support tools. Improvements in these specific areas - all dependent on health IT integration - have been shown to impact the overall quality of care. The program will include special attention to the delivery of high quality care from providers in rural, small community, safety net, and community health center environments. In addition, AHRQ will continue to fund planning and implementation of health IT solutions in communities that demonstrate the value of health IT in patient safety, quality, and health care costs. 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 health care system. The remaining $28 million in AHRQ's patient safety budget supports a variety of activities. In FY 2006, AHRQ provided $3 million in contract funds to initiate activities authorized under the Patient Safety and Quality Improvement Act of 2005. This law establishes patient safety organizations (PSO) nationwide that will collect information about adverse events affecting patient safety, in order to allow for the analysis of such events and development of solutions to decrease their incidence. The major activities in FY 2006 include establishing and maintaining a system to:
AHRQ will continue funding these activities in FY 2007. In addition, a new round of investigator-initiated patient safety grants will be awarded to build on the investments first funded in FY 2001 following the release of the Institute of Medicine's (IOM) 1999 report, To Err is Human: Building a Safer Health System. Effective Health Care Program: The FY 2007 budget provides $15 million in continued support related to Section 1013 of the MMA for the Effective Health Care Program. AHRQ's Effective Health Care Program helps policymakers, clinicians, and patients determine which drugs and other medical treatments work best for certain health conditions. Thirteen new research centers, as well as an innovative center for communicating findings, were named as part of the three-part program. The $15 million program supports the development of new scientific information through research on the outcomes of health care services and therapies, including drugs and by comparing different therapies for the same condition. By reviewing and synthesizing published and unpublished scientific studies, as well as identifying important issues where existing evidence is insufficient, the program helps provide policymakers, clinicians, and patients with better information for making treatment decisions. Initial reports from the new program were issued this fall, with particular focus on effectiveness of information relevant to Medicare beneficiaries. A new Web site for the program, www.effectivehealthcare.ahrq.gov, has been developed and provides a venue for stakeholders to comment on draft reports and to suggest research topics. The new program includes three components:
AHRQ is partnering in this program with the Centers for Medicare & Medicaid Services. As Medicare launches its new drug benefit program this year, it will become increasingly important to have sound information about which drugs and other treatments are proven to be effective for the conditions that are most important for its beneficiaries. Additional priority areas for the program will be identified by the Secretary this year to include the needs of Medicaid and State Children's Health Insurance Programs, as well as Medicare. Public comments are already being solicited for the additional set of priority conditions. Research and Dissemination Activities Outside Patient Safety: In FY 2007, AHRQ will invest $162 million in research and dissemination activities in prevention, pharmaceutical outcomes, and other research 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 Centers for Education and Research Therapeutics 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 recently issued a report on the effects of omega-3 fatty acids in child and maternal health; this research had been requested by the National Institute of Health's Office of Dietary Supplements. AHRQ will continue to sponsor the U.S. Preventive Services Task Force (USPSTF). The USPSTF has issued clinical recommendations on obesity in children, genetic susceptibility testing for breast and ovarian cancer, glaucoma, and screening for abdominal aortic aneurism in 2005. The Task Force also issued the Pocket Guide to Clinical Preventative Services - a consolidation of recommendations from 2001-2004 in 2005. Medical Expenditure Panel Surveys (MEPS)The FY 2007 budget for MEPS includes a request for $55 million, the same as FY 2006. 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, 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. The reports 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 2006 report. The current editions of the 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, healthplans, policymakers, purchasers, patients and consumers to take effective steps to improve quality. In FY 2007, AHRQ will be completely funded through inter-agency transfers of evaluation funds. FY 2007 Ambulatory Patient Safety Program Objectives
AHRQ's Patient Safety Improvement Corp (PSIC) training program, established in 2003, seeks to improve patient safety by providing knowledge and skills to teams of State field staff and hospital partners selected by States. One of AHRQ's long-term goals is to successfully deploy hospital practices such that medical errors are reduced nationwide by 2010. As of 2005, 34 states and 48 hospitals/health care systems have participated in the PSIC and have on-site patient safety experts trained through this program. Efforts continue in FY 2006 to deploy on-site patient safety experts trained through the PSIC program in 15 additional states and major health care systems. In FY 2007, the measure is to have 50 participants in the PSIC train-the-trainer program initiate local patient safety training activities. |
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Last revised: February 20, 2006
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