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The Budget in Brief summarizes the President's Fiscal Year 2002 budget request for the Agency for Healthcare Research and Quality (AHRQ). Select to access details from the Budget Justification.
Overview of the Budget Request
FY 2002 Budget Request
The mission of the Agency for Healthcare Research and Quality (AHRQ) is to:
- Improve the outcomes and quality of health care services.
- Reduce its costs.
- Address patient safety.
- Broaden effective services through establishment of a broad base of scientific research and through promotion of improvements in clinical and health systems practices, including prevention of disease.
AHRQ is 1 of the 13 components of the Department of Health and Human Services (HHS). AHRQ works closely with the other HHS components, including the National Institutes of Health and the Centers for Disease Control and Prevention. The products of the Agency include knowledge that supports decisionmaking to improve health care, as well as tools that assist in efforts to improve quality and reduce costs.
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Overview of the Budget Request
For Fiscal Year (FY) 2002, the President has requested from Congress an appropriation of $306,245,000, an increase of $36,449,000 (13.5 percent) over the Agency's FY 2001 appropriation. The increase of $36 million provides support for research and training grants, the National Healthcare Quality Report, patient safety data development, information technology, the National Healthcare Disparities Report, the Medical Expenditure Panel Survey (MEPS), and research management costs. The $36 million increase is arrayed below by the Agency's budget categories: Research on Health Costs, Quality and Outcomes (HCQO), Medical Expenditure Panel Survey (MEPS), and Program Support (PS).
Increase in Budget Request (Thousands of Dollars)
|Research and Training Grants
|The National Quality Report
|Patient Safety Data Development
|The National Disparities Report
|Medical Expenditure Panel Survey
*HCQO: Health Costs, Quality, and Outcomes.
**MEPS: Medical Expenditure Panel Survey.
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FY 2002 Budget Request
Research and Training Grants—$16,063,000
The FY 2002 request includes $16.1 million in FY 2002 to fund research and training grants. There is no better way to increase the breadth and productivity of research approaches than to actively support and encourage innovative, peer-reviewed investigator-initiated research. This strategy has been fundamental in the success of the Nation's biomedical research and is just as important in research on health care quality, outcomes, cost, use and access. In describing the funds available for investigator-initiated research, AHRQ will stress the need for applications that cover at least one of three broad areas of health services research:
- Improving patient-centered health care.
- Structuring, financing, and managing high-quality, efficient care delivery systems.
- Informing those who make health care decisions—from patients to policymakers—on ways to implement the lessons learned from research
Improving Patient-Centered Health Care. It is widely acknowledged that patients, more educated than ever about their health care, should be as active as they wish in decision-making regarding their care. For this to occur, both technical care and interpersonal interactions must be centered around the needs and preferences of individual patients. Research has shown that this approach yields better outcomes. As a result, health services research should be able to do more to identify and disseminate widely information about the factors that create an ideal environment for patient-centered care. As the recent Institute of Medicine (IOM) report, Bridging the Quality Chasm, stated, we must "modify the care to respond to the person, not the person to the care."
Structuring, Financing, and Managing High-Quality, Efficient Care Delivery Systems. Health care in the United States is provided within large systems, with complex funding streams. To improve the quality and efficiency of that care, providers, purchasers and policy-makers need knowledge about how these systems operate and how different financial and organizational arrangements affect health care.
The IOM report identified a "chasm" between the health care we have and the health care we could have. It also identified that this gap to a large extent springs from two overarching system features:
- The way we pay for care.
- The way we structure the organizations that provide it.
The second broad category for AHRQ's FY 2002 research grant portfolio could address questions such as:
- How do different payment methodologies and financial incentives affect quality, access and cost of care?
- How can payment arrangements be better designed to provide appropriate incentives to both patients and providers and to enhance patient-centered knowledge of and compliance with treatment regimens?
- How does consumer and patient decisionmaking influence payment policies?
- How do different patterns and levels of market competition affect the quality and cost of care? Of particular interest would be the impact of employer and coalition efforts on the quality and cost-effectiveness of care in the marketplace, the impact of State efforts to monitor and improve access and quality, and the impact of public and private payment changes on the health care safety net.
- What organizational structures and processes are most likely to sustain high-quality, efficient health care?
Informing Those Who Make Health Care Decisions—from patients to policymakers—on ways to implement the lessons learned from research. While research in the previous two categories could lead to new knowledge and tools, important questions about how to translate research findings into improvements for patients and consumers, clinicians and health care delivery systems and policymakers is essential.
Although many strategies have been developed to translate research into practice, developing new methodologies and evaluating which existing methodologies have the most meaningful impact is a priority for all AHRQ research. By translating research into practice, this part of AHRQ's investigator-initiated portfolio could complete the research pipeline and yield more immediate improvements in Americans' health care.
Recent and ongoing research is providing important insights regarding translation of evidence-based programs into practice, most often for individuals with specific clinical conditions (e.g., children with asthma, diabetes), and efforts to assess quality of care now provide both a stimulus for change and benchmarks for improvement.
The National Healthcare Quality Report—$4,000,000 (including $2,000,000 for MEPS)
The FY 2002 request includes $4 million for continued internal and external development of the National Healthcare Quality Report (NQR). This investment will support the acquisition of relevant non-federal data for the report, data processing and analysis for the first NQR, assessment and development of quality measures for the ongoing improvement of the report, and the design of NQR reporting products. In addition, these funds will be applied to enhancements of data-collection efforts at the Agency. These data-collection enhancements foster the development of information on health care disparities, chronic conditions in specific populations (e.g., children), medical errors, the quality of emergency services, and the receipt of needed services.
Patient Safety Data Development—$3,000,000
In the wake of the Institute of Medicine report, To Err Is Human, many organizations, particularly States, are considering developing medical error data-collection systems. The FY 2002 request includes $3 million to enable AHRQ to work with CDC, the Food and Drug Administration (FDA), and the Health Care Financing Administration (HCFA) in developing a common vocabulary to link existing patient safety reporting systems and to assist those who develop such systems.
The Agency received $50 million in FY 2001 to:
- Develop an integrated set of activities to design and test best practices for reducing medical errors in multiple settings of care.
- Develop the science base to inform these efforts; to improve provider training in the reduction of errors.
- Capitalize on the advances in information technology to translate proven effective strategies into widespread practice.
- Build the capacity to further reduce errors in the future.
These activities will be ongoing in FY 2002, in addition to the work supported by the FY 2002 increase of $3,000,000.
AHRQ requests $3 million to meet the requirements of several new laws and directives focusing on information technology, particularly the Workforce Investment Act of 1998, the Government Paperwork Elimination Act, and the AHRQ Information Technology Disaster Recovery program.
The National Healthcare Disparities Report—$2,000,000 (including $1,000,000 for MEPS)
For FY 2002, the Agency requests $2 million to fund the work necessary to develop the National Healthcare Disparities Report, as mandated in AHRQ's reauthorization. This project will use data from numerous sources and will require AHRQ to participate in substantial data acquisition, measurement analysis and data processing to produce the type of high-quality product that is typical of AHRQ and is expected by Congress. One million dollars will be set aside for this work. The remaining $1 million will be provided to MEPS to support enhancements, in particular to permit analyses by race and ethnicity and socioeconomic status, which will provide data for the report.
MEPS—$4,650,000 (plus $3,000,000 included in projects above)
The request also provides $48,500,000 for continued funding for the Medical Expenditure Panel Survey (MEPS), an increase of $7,650,000 from the FY 2001 level of $40,850,000. This request includes $4,650,000 for FY 2000 and FY 2001 enhancements to the sample size and content of the MEPS Household and Medical Provider Components. In addition, this level includes $3,000,000 for enhancements to support the congressionally mandated reports described above.
In FY 2002, AHRQ requests $3.7 million for research management costs. These funds will provide for mandatory costs such as space, pay raise, and inflation.
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For More Information
For more information, access the FY 2002 Budget Justification.