FY2020 budget request calls for AHRQ consolidation and less or no funding for some programs

March 20, 2019

Major changes have been presented in the President’s FY2020 Budget request, including less funding for the Agency for Healthcare Research and Quality’s (AHRQ’s) highest priority activities. The President’s Budget also proposes AHRQ be consolidated into the National Institutes of Health (NIH) as the National Institute for Research on Safety and Quality (NIRSQ), said the agency in a public announcement released yesterday afternoon. Funding for Health Information Technology and Patient-Centered Outcomes Research were hit the hardest.

The President’s FY2020 Budget request includes:

Patient Safety: This research portfolio prevents, mitigates, and decreases patient safety risks and hazards, and quality gaps associated with healthcare. NIRSQ will provide $65.3 million, a decrease of $7.0 million from the prior year. Of this total, $32.5 million will support research grants and contracts to advance the generation of new knowledge and promote the application of proven methods for preventing healthcare-associated infections (HAIs), with $12 million of that sum invested in the national Combating Antibiotic-Resistant Bacteria enterprise.

Health Services Research, Data and Dissemination: HSR funds foundational health services research through research grant support to the extramural community. NIRSQ will provide $39.9 million for non-competing research grant support. A total of $3.1 million is provided for new investigator-initiated research grants. NIRSQ proposes to request investigator-initiated applications targeting research focused on two of the nation’s most pressing health care issues: Opioid Abuse and transforming to a value-based delivery. Health Services Research Contracts total $15.0 million, including $4.5 million to accelerate evidence on preventing and treating opioid abuse in primary care, especially in older adults. In total, the FY 2020 President’s Budget provides $6.0 million in funding to support the Secretary’s initiative to combat opioid abuse, misuse, and overdose.

Health Information Technology: The FY 2020 President’s Budget ends dedicated funding for health information technology. Instead, health IT research NIRSQ-8 will compete for related funding opportunities within patient safety and health services research to ensure the highest priority research is funded.

U.S. Preventive Services Task Force: The U.S. Preventive Services Task Force is an independent, volunteer panel of nationally-recognized experts in prevention and evidence-based medicine whose mission is to improve the health of all Americans through evidence-based recommendations regarding the effectiveness of clinical preventive services and health promotion to the general population. A reduction of $4.2 million in FY 2020 will reduce the number of recommendations the USPSTF will make from an average of 12 recommendations per year to 6 recommendations in FY 2020.

Medical Expenditure Panel Survey: The Medical Expenditure Panel Survey is the only national source for comprehensive annual data on how Americans use and pay for medical care. The survey collects detailed information from families on access, use, expenses, insurance coverage and quality. A total of $70.0 million is required to provide ongoing support to the MEPS, allowing the survey to meet the precision levels of survey estimates, maximize survey response rates, and maintain the timeliness, quality and utility of data products specified for the survey in prior years. In addition, an increase of $1.8 million is provided to augment both the sample by 1,000 completed households (2,300 persons) and to redistribute the sample across states.

Research Management & Support: RMS activities provide administrative, budgetary, logistical, and scientific support in the review, award, and monitoring of research grants, training awards, and research and development contracts. As the organization transitions to the NIH as an Institute, some programmatic activities will end. This reduction in scope will require a decrease of 39 FTEs in FY 2020 from the FY 2019 Enacted level, anticipated to be achieved through attrition, retirements, and a reduction in force if necessary. A total $53.6 million has been requested, a decrease of $17.7 million.

Patient-Centered Outcomes Research Trust Fund: AHRQ’s total program level at the FY 2020 President’s Budget no longer includes mandatory funds from the PCORTF. This mandatory funding stream ($112.5 million) ends in FY 2019. The end of the PCORTF could affect the Agency’s ability to ensure evidence from patient centered outcomes research which is used by healthcare systems and professionals to improve the quality, safety, and value of healthcare. NIRSQ will use carryover resources until expended to disseminate and implement PCOR research findings and other alternatives.

AHRQ has the full report.