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House subcommittee bill proposes to defund and terminate AHRQ

An appropriations bill wending its way through the U.S. House of Representatives calls to terminate AHRQ. The health care group NAPH fires back.

Congressional efforts to defund the Agency for Healthcare Research and Quality, which conducts health IT research and analysis, are being met with resistance by some organizations.

"Effective October 1, 2012, the Agency for Healthcare Research and Quality [AHRQ] is terminated," read a draft of a bill slated for markup this week by the U.S. House of Representatives' Labor, Healthand Human Services, Education, and Related Agencies Appropriations Subcommittee.

The bill would defund the AHRQ as an entity, but would carry on some of its initiatives already in progress, including activities related to the Office of the National Coordinator for Health IT (ONC), the Centers for Disease Control and Prevention's ongoing quality initiatives, and the Office of the Assistant Secretary for Health's patient safety activities.

The bill also proposed to abolish support for any patient-centered outcomes research.

"The members of the Subcommittee and staff have worked diligently to put forward a good bill that balances the realities of our dire fiscal situation with the need to protect our most vulnerable citizens in the face of these continued economic woes," said House Appropriations Committee Chair Hal Rogers (R-Ky.). "Overall, this bill rightsizes these departments and agencies, providing roughly $150 billion in funding, which is $6.3 billion below last year and some $8.8 billion below the President's request."

We must not let this misguided move against AHRQ set back efforts to improve the safety, quality and effectiveness of care.

Dr. Bruce Siegel, president, NAPH

Several AHRQ projects advocate the use of health IT to improve patient care quality, including the Health IT Hazard Manager Tool. The agency also sponsors research to measure outcomes in patient care where caregivers use health IT tools, such as its 2010 review of 162 studies titled Impact of Consumer Health Informatics Applications. Health IT figures prominently in its National Quality Strategy and Patient Centered Medical Homes initiatives as well.

The AHRQ also is funding the conversion of its system of health care quality indicators from ICD-9 to ICD-10. The agency currently is seeking nominations for members of 10 multidisciplinary workgroups it plans to convene for tackling that task.

One of the first health care groups to respond to the draft bill was the National Association of Public Hospitals and Health Systems (NAPH).

"We must not let this misguided move against AHRQ set back efforts to improve the safety, quality and effectiveness of care," said Dr. Bruce Siegel, president of NAPH, in an email statement. "Safety net providers' innovative work to end health care disparities and ensure access to care for all people, regardless of ability to pay, demands robust federal support and a strong national commitment to the safety net."

Siegel went on to say that NAPH members strongly support AHRQ research, and partner with the agency on initiatives to find and use best practices for improving quality and value at safety net institutions. Specific AHRQ-funded examples include the University of New Mexico Health Sciences Center's Project ECHO, which remotely connects disease experts at urban medical centers with rural general practitioners and community health workers to care for the chronically ill. Another initiative is Boston Medical Center's Project RED, which investigates workflow improvements to increase patient safety and decrease readmissions.

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