Overview:
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The Agency for Healthcare Research and Quality (AHRQ) sponsors research to improve the quality of health care in America. As part of the Department of Health and Human Services, AHRQ is tasked with elevating health care quality, reducing medical-related costs and expanding healthcare access for more Americans. Almost 80% of AHRQ’s budget is awarded as grants and contracts to researchers at universities and other research institutions across the country. Early in its history, the agency became heavily involved in a controversial healthcare reform plan that almost led to AHRQ being eliminated. Since then, the agency has maintained a low profile, low on controversy.
History:
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Following in the footsteps of the National Center for Health Services Research, the Agency for Healthcare Policy and Research (AHPR) was created in 1989 with a ten-year life-span and the directive to “support research designed to improve the quality, safety, efficiency and effectiveness of health care for all Americans.” During its first years, AHPR attempted to improve medical practice by carrying out large multidisciplinary, multi-institutional projects that focused on patient results in certain medical conditions. The agency eventually abandoned this approach because it proved expensive and had little impact on clinical practice.
The agency also tried to address healthcare cost savings by developing practice guidelines for conditions such as low back pain. Some medical professionals were unhappy with the recommendations and criticized AHPR for interfering with the practice of medicine. The agency subsequently dropped the effort. But the agency’s biggest blunder was getting involved in the healthcare reform plan of Bill and Hilary Clinton in the early 1990s. AHPR officials worked closely with the White House on the Clinton’s plan, and Republicans, after taking control of Congress 1994, didn’t forget the agency’s involvement.
In 1995, the GOP controlled Congress and considered eliminating AHPR as part of a larger plan to cut government spending. The Agency for Health Care Policy and Research managed to survive the threat, and agency officials came away with a more cautious attitude towards its work thereafter. As one assessment of the agency put it, officials learned the lesson “of avoiding activities that may generate negative political fallout.”
In 1999, the agency’s mandate was set to expire. Congress decided to extend AHPR’s existence, but only after some changes were made. Most importantly, its name was altered to the Agency for Healthcare Research and Quality (AHRQ). “Policy” was deliberately removed from the name because of the perception that it would continue to identify the agency with the failed Clinton healthcare reforms. Also, the reauthorization legislation eliminated references to practice guidelines and stated explicitly that the agency was not a regulatory body.
Agency for Health Care Policy and Research Studies Own History to Avoid Repeating Past Mistakes (Robert Wood Johnson Foundation)
What it Does:
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Part of the Department of Health and Human Services, the Agency for Healthcare Research and Quality is responsible for supporting research designed to improve the quality of health care, reduce its cost and broaden access to essential services among Americans. AHRQ seeks to inform both healthcare professionals and consumers about research findings, clinical information and data and surveys that lead to an improved understanding of the medical delivery system. Almost 80% of AHRQ’s budget is awarded as grants and contracts to researchers at universities and other research institutions across the country.
AHRQ’s primary offices are:
- Office of Performance Accountability, Resources, and Technology directs and coordinates the agency’s program planning and evaluation activities and administrative operations.
- Office of Extramural Research, Education and Priority Populations directs the scientific review process for grants and Small Business Innovation Research (SBIR) contracts. It also manages agency research training programs, evaluates the scientific contribution of proposed and ongoing research, demonstrations and evaluations and supports and conducts health services research on priority populations.
- Office of Communications and Knowledge Transfer manages programs for disseminating the results of agency research to various groups in the healthcare industry as well to the public.
- Center for Outcomes and Evidence conducts and supports research and assessment of health care practices, technologies, processes and systems.
- Center for Primary Care, Prevention, and Clinical Partnerships works to better inform clinical providers and patients about best practices to employ in the area of primary care.
- Center for Delivery, Organization, and Markets serves as an interdisciplinary team to identify emerging research needs, manage research grants and contracts, conduct and publish peer-reviewed research and develop databases and software tools. These activities often are carried out in collaboration with others in the agency and through partnerships with public and private parties outside of AHRQ.
- Center for Financing, Access and Cost Trends conducts, supports and manages studies of the cost and financing of health care, the access to health care services and related trends. CFACT also develops data sets to support policy and behavioral research and analyses.
- Center for Quality Improvement and Patient Safety conducts and supports research on patient safety and health care quality measurement, reporting and improvement. It also disseminates reports and information on health care quality and improvement.
- National Advisory Council for Healthcare Research and Quality is 21-member panel comprised of private-sector experts who share their perspectives on the health care system with agency leaders. The members represent health care plans, providers, purchasers, consumers and researchers. Also serving in an ex-officio capacity are representatives of seven federal agencies that address health care system issues: The National Institutes of Health; Department of Defense (Health Affairs); the Centers for Disease Control and Prevention; the Department of Veterans Affairs; the Office of Personnel Management; the Food and Drug Administration; the Centers for Medicare & Medicaid Services; and the Assistant Secretary for Health.
Research Activities Newsletter
Where Does the Money Go:
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The Agency for Healthcare Research and Quality spent more than $960 million from 2000 to 2008 on contracts to private companies and public entities, according to USAspending.gov. Of the 619 recipients of AHRQ contracts, the top 10 were:
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Westat, Inc
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$363,082,579
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Social & Scientific Systems
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$53,602,531
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Research Triangle Institute
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$43,532,123
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Emergency Care Research Institute
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$31,423,379
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National Opinion Research Center
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$26,685,066
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Thomson Company Inc
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$24,680,365
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Oregon Health & Science University
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$24,608,949
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Booz Allen Hamilton Inc.
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$24,231,318
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Hopkins Johns University
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$23,497,500
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Rand Corporation
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$16,442,390
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Information about grants awarded by AHRQ is available through the agency’s grants online database. Grants can be researched by a variety of categories: Quality and Outcomes; Use; Cost; Access; Knowledge; or All Categories. Dozens of sub-categories are also available to further refine searches.
Additional information on agency
is also available on the Web.
- Table of Contents
- Overview
- History
- What it Does
- Where Does the Money Go
- Controversies
- Suggested Reforms
- Comments
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Agency for Healthcare Research and Quality
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