Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality[1] (AHRQ; pronounced "ark" by initiates and often "A-H-R-Q" by the public) is one of twelve agencies within the United States Department of Health and Human Services (HHS).[2] The agency is headquartered in North Bethesda, Maryland, a suburb of Washington, D.C. (with a Rockville mailing address). It was established as the Agency for Health Care Policy and Research (AHCPR) as a constituent unit of the Public Health Service (PHS) under the Omnibus Budget Reconciliation Act of 1989 (103 Stat. 2159), December 19, 1989, to enhance the quality, appropriateness, and effectiveness of health care services and access to care by conducting and supporting research, demonstration projects, and evaluations; developing guidelines; and disseminating information on health care services and delivery systems.

However, AHCPR became controversial when it produced several guidelines that some thought would reduce medical drugs and procedures. This included concern from ophthalmologists on a cataract guideline and concern by the pharmaceutical industry over a reduction in the use of new drugs. When the agency produced a guideline that concluded that back pain surgery was unnecessary and potentially harmful, a lobbying campaign aided by Congressmen whose backs had been operated on changed the name of the agency and scaled back the guidelines program, which now exists as the National Guideline Clearinghouse.[3] AHCPR was reauthorized December 6, 1999, for Healthcare Research and Quality (AHRQ) under the Healthcare Research and Quality Act of 1999,[2] which amended Title IX of the Public Health Service Act (42 U.S.C. 299 et seq).

History

During its early years, the Agency for Healthcare Policy and Research implemented large multidisciplinary, multi-institutional projects that focused on patient results in certain medical conditions in an effort to improve clinical practice. This has included basic health IT research, patient safety research on wrong site surgery, medical teamwork, and hospital acquired conditions such as MRSA and VRE.

Funding

The Trump administration proposes to merge the Agency for Healthcare Research and Quality with the National Institutes of Health. The President's FY 2018 Request to Congress for the Agency was for $378.5 million.

The 2015 budget for AHRQ is US$440 million,[4] $24 million less than FY 2014. Within this total, the budget includes $334 million in Public Health Service (PHS) Evaluation Funds, a decrease of $30 million from FY 2014, and $106 million from the Patient-Centered Outcomes Research Trust Fund, an increase of $13 million above FY 2014.

The FY 2015 budget is intended to ensure the Agency continues its progress on health services research to improve outcomes, affordability, and quality. The budget also supports the collection of information on health care spending and use through the Healthcare Cost and Utilization Project (HCUP) and Medical Expenditure Panel Survey (MEPS).

The FY 2015 budget provides $73 million, an increase of $1 million from FY 2014, for AHRQ's patient safety research and dissemination projects that prevent, mitigate, and decrease the number of medical errors, patient safety risks and hazards, and quality gaps. The budget includes $23 million, a $6 million decrease from FY 2014, for health information technology (health IT) research, and the development and dissemination of evidence and evidence-based tools to inform policy and practice on how health IT can improve the quality of American health care. In FY 2015, AHRQ will provide $20 million to support 40 grants for foundational health IT research to inform and support the meaningful use of health IT.

In July 2018, the National Guideline Clearinghouse (NGC) and the National Quality Measures Clearinghouse (NQMC),[5] two longtime online resources from the AHRQ, were shut down because federal funding ceased to be available to them.[6][7][8][9] Other stakeholders were exploring options for hosting the NGC [10]]; should that happen, it will return to the web.

Leadership

Gopal Khanna, MBA was appointed as Agency director on May 9, 2017. Prior to that, Dr. Andrew Bindman was the director of AHRQ from April 2016 until January 2017. Prior to joining AHRQ, Dr. Bindman served as faculty of UCSF School of Medicine.[11] Sharon Arnold Ph.D. was acting director from February - April 2016, replacing Richard Kronick in February 2016. Richard Kronick, Ph.D. was director from 2013 to March 2016. Carolyn Clancy M.D. was the director from 2002- 2014.

Divisions

The Agency has multiple offices and centers including the Center for Evidence and Practice Improvement (CEPI), the Center for Financing, Access and Trends, the Center for Delivery, Organization and Markets, the Center for Quality and Patient Safety, the Office of Management Services, the Office of Extramural Research and Priority Populations, and the Office of Communications. The Office of Communications was previously known as the Office of Communications and Knowledge Transfer.[12]

Within CEPI, the Evidence-Based Practice Centers[13] (EPCs) develop evidence reports and technology assessments on topics relevant to clinical and other health care organization and delivery issues—specifically those that are common, expensive, and/or significant for the Medicare and Medicaid populations. With this program, AHRQ serves as a "science partner" with private and public organizations in their efforts to improve the quality, effectiveness, and appropriateness of health care by synthesizing the evidence and facilitating the translation of evidence-based research findings. Topics are nominated by Federal and non-Federal partners such as professional societies, health plans, insurers, employers, and patient groups.[14]

References
  1. "Agency for Healthcare Research and Quality home page". United States Department of Health and Human Services.
  2. "Healthcare Research and Quality Act of 1999". Agency for Healthcare Research and Quality. United States Department of Health and Human Services.
  3. Avorn J. Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs, pp. 277–288. Random House.
  4. 2015 Department of Health and Human Services Budget-in-Brief Archived 2014-07-23 at the Wayback Machine, pg 10, United States Department of Health and Human Services, Accessed 2015-07-14
  5. "National Quality Measures Clearinghouse (NQMC)". Ahrq.gov. Retrieved 26 November 2018.
  6. "AHRQ: National Guideline Clearinghouse to Shut Down July 16". Aafp.org. Retrieved 26 November 2018.
  7. "HHS eliminates 20 years of evidence-based medical guidelines". Healthcareitnews.com. 12 July 2018. Retrieved 26 November 2018.
  8. "Federal clinical guidance database to shut down because of funding cuts". Healthdatamanagement.com. Retrieved 26 November 2018.
  9. "HIT programs at risk as AHRQ faces elimination". Healthdatamanagement.com. Retrieved 26 November 2018.
  10. "AHRQ Shutters Guideline Site, But ECRI to Carry the Torch". Medpagetoday.com. 20 July 2018. Retrieved 26 November 2018.
  11. "Archived copy". Archived from the original on 2016-06-30. Retrieved 2016-05-24.CS1 maint: archived copy as title (link)
  12. "Statement of Organization, Functions, and Delegations of Authority". federalregister.gov. 15 April 2016.
  13. "Archived copy". Archived from the original on 2016-05-23. Retrieved 2016-05-24.CS1 maint: archived copy as title (link)
  14. "Evidence-based Practice Centers (EPC) Program Overview". Agency for Healthcare Research and Quality. Retrieved 29 April 2016. This article incorporates text from this source, which is in the public domain.
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