What Trump’s budget proposal may mean for health research agency

President Donald Trump’s budget proposal includes rolling a relatively obscure agency that conducts health care research into the National Institutes of Health, and cutting the NIH budget by $5.8 billion.

That small agency – the Agency for Healthcare Research and Quality, or AHRQ (pronounced “arc“)  – could be cut entirely or see its mission shrink drastically under the president’s plan. Reducing or eliminating AHRQ would have a significant effect on health system research and health IT adoption in communities across the country. Reporters have a number of ways to see how changes to AHRQ could affect health services in their region.

The president’s proposed budget doesn’t say how AHRQ would be integrated into the NIH, but considering the steep cuts to the NIH overall, AHRQ’s future funding doesn’t look bright.

This isn’t the first time AHRQ has been on the chopping block. A draft House bill for fiscal year 2016 called for the agency’s elimination. HHS Secretary Tom Price also has advocated wiping out AHRQ.

What does AHRQ do, exactly? Since its founding in 1989, AHRQ has supported health services research (as opposed to biomedical research) to improve the safety, effectiveness and quality of health care services. Many reporters interact with AHRQ through its hospital quality measures and the many research projects that use AHRQ data sources.

In 2015, Alan Weil, editor in chief of Health Affairs, expressed grave concern about the loss of AHRQ in a column “We’d be in the dark without AHRQ.“ AHRQ produces three data sources that are important to health delivery research: the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys; the Healthcare Cost and Utilization Project (HCUP) databases; and the Medical Expenditure Panel Survey (MEPS). The MEPS surveys are the number one data source for Health Affairs, Weil wrote.

AHRQ is the “evidence engine“ for physicians to make informed decisions about care quality, safety and effectiveness, according to the American College of Physicians. “Simply folding AHRQ into NIH could harm the vital work that AHRQ performs,” said ACP President Nitin Damle, in a statement.

AHRQ sponsors accreditation of patient-centered medical homes. Hospitals and health systems that seek to gain status as a medical home often go through the process outlined and approved by AHRQ. Reporters covering medical home models often look to accreditation by AHRQ to see how serious health systems are taking the medical home implementation.

And since 1998, AHRQ convenes and supports the U.S. Preventive Services Task Force, which issues recommendations on preventive care that is used by providers nationwide.

AHRQ’s Health IT portfolio issues best practices and the latest research on health IT effectiveness and implementation. The agency has awarded grants to more than 180 institutions nationwide on health IT. Health IT tools on e-prescribing, patient Web portals, electronic health records and clinical decision support are produced by the agency. An AHRQ toolset has helped many physicians and pharmacists implement e-prescribing, for example.

The hashtag #saveAHRQ is trending on Twitter, with researchers, clinicians and major medical associations rallying behind the agency.

There are many ways to find out the impact of AHRQ on your community. You can do a search on AHRQ’s website under Funding and Grants to see grants issued in your region. You can also ask hospitals and community health centers you cover if they use AHRQ tools, training materials or research reports to inform decision-making. A Health Affairs search can also reveal whether local health policy researchers have used AHRQ data sources in their work.

Certainly, reporters will have fewer reliable tools to gauge health system performance without AHRQ (or with a severely limited agency), so there’s that to consider when covering the impact of the president’s budget proposal on your local community.

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