On June 24, the House Appropriations Committee will vote on legislation that would eliminate funding for the Agency for Healthcare Research and Quality (AHRQ). Compared with the National Institutes of Health (NIH) or the Centers for Disease Control (CDC), AHRQ is virtually unknown to the public, but its work can have just as much influence on the health care of all Americans.
The agency sponsors a broad range of health services research on how health care is delivered and paid for in this country. The backbone of that work is the Medical Expenditure Panel Survey (MEPS), which has been conducted since 1996. MEPS is a unique resource. It is the only national source of annual data on how Americans, including the uninsured, use and pay for health care.
Zeroing out AHRQ’s budget would seriously undermine the research and data collection now conducted by that agency. Yes, MEPS could be transferred to CDC, for example, but without additional funding, CDC would be forced to make decisions about what to cut to make the expanded work fit within a smaller budget. Yes, the research studies now sponsored by AHRQ could be transferred to NIH, but inevitably the focus of the research would shift away from issues essential to the next round of health reforms.
This is not to say that NIH or CDC should not receive additional funds, or that the money that is spent by AHRQ and its sister agencies is being used efficiently and for only the most important questions. As the former director of research and demonstrations in what was then called the Health Care Finance Administration (now the Centers for Medicare and Medicaid Services, or CMS), I can attest to the challenges of anticipating what questions will matter to produce information that will be useful in time for policymakers to act. But I can also assure the reader that the kind of research conducted by CMS in its Innovation Center is focused narrowly on Medicare and Medicaid, and does not provide the broader perspective that AHRQ can bring to policy issues.
Part of AHRQ’s problem is that it deals with issues that are not popular and do not resonate with the public. AHRQ will not produce a cure for a dread disease, and it will not work to stem an epidemic before it spreads across the country. AHRQ’s work is, let’s face it, boring — but no less important. We may not be enthralled by a study of how to prevent hospital-based infections, but such studies can change the way health care is delivered on the ground — which can improve patient experience and reduce cost.
So how about this: level funding for AHRQ in 2016, which is the same as a 5% cut when you take inflation into account. As part of the deal, Congress should take a close look at what AHRQ is actually doing, with an eye to redefining AHRQ’s research to be more relevant and more effective. The next president may well appreciate having AHRQ’s expertise available for the next health care reform.
from AEI » Latest Content http://ift.tt/1K8Lnlr
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