The Budget in Brief summarizes the President's Fiscal Year (FY) 2003 budget request for the Agency for Healthcare Research and Quality (AHRQ).
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.
For Fiscal Year (FY) 2003, the President has requested from Congress an appropriation of $251,700,000, a decrease of $48,659,000 (16.2 percent) from the Agency's FY 2002 appropriation. The request provides a $5 million increase for the Secretary's Patient Safety Initiative, maintains funding for several priority programs, provides no new funds for non-patient safety research and training grants, and reflects a $33,754,000 general reduction to grant and contract commitments.
In addition, the request will provide $5,000,000 in new funds for patient safety as well as increases in research management, including costs related to consolidating AHRQ space.
Within our total request, AHRQ will provide $10,000,000 to the Department of Commerce to be used for the Current Population Survey. The request level will require reductions to some combination of research grant, research contract, and Inter-Agency Agreements.
|Department of Commerce: Current Population
|Secretarial Initiative to Improve Patient Safety:
|Medical Expenditure Panel Survey (MEPS)
|Accrued Retirement and Health Benefits Costs
|Non-Patient Safety Research and Training Grants
|Non-Patient Safety Contracts
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Department of Commerce's Current Population Survey: + $10,000,000
AHRQ's request includes $10,000,000 in FY 2003 to cover the annual cost to support a sample expansion to the Department of Commerce's Current Population Survey. In addition to sample expansion, these funds will support enhanced analytical content in order to improve the accuracy of State estimates of the uninsured and improve the measurement of the SCHIP expansions.
Secretarial Initiative to Improve Patient Safety: + $5,000,000
In addition to the $55,000,000 appropriated in FY 2002, AHRQ requests $5,000,000 of new funds for activities that promote the translation of patient safety research into programs and products for health care systems with the goal of having measurable improvement in the safety of healthcare for Americans. This will be done in two ways: challenge grants ($3,000,000) and on-site patient safety experts ($2,000,000).
Challenge Grants. In July, 2001 the Agency released a report, entitled Making Health Care Safer: A Critical Analysis of Patient Safety Practices, which examined the evidence supporting 79 promising patient safety interventions. Many of these proven lifesaving interventions, such as the use of medications to reduce the risk of heart attacks and infections in surgical patients, are not consistently implemented. The $3,000,000 will be used to implement local safety improvement priorities through challenge grants that will provide incentives to put systems-based interventions in place in healthcare organizations.
On-site Patient Safety Experts. In FY 2001 the Agency initiated a review of various models, including those from the CDC's Epidemic Intelligence Service (EIS) program and the Agriculture Extension program, which will inform the development of a program to train patient safety experts. The trainees will be used to improve local capacity in field assignments where they will provide technical assistance on information management, on-site assistance of experts in patient safety, support of regional health initiatives, and assistance in using administrative, regulatory, and payment mechanisms to support a culture of safety. The FY 2003 request will allow us to begin implementation of this training program.
Medical Expenditure Panel Survey: + $4,800,000
The FY 2003 Request for the Medical Expenditure Panel Survey (MEPS) totals $53,300,000, an increase of $4,800,000 from the FY 2002 level. The increase consists of continuation costs from prior year enhancements ($3,800,000) and enhancements to the MEPS insurance component ($1,000,000).
Continuation Costs. The FY 2003 Request for MEPS includes continuing costs of $3,800,000 for FY 2002 enhancements to the sample size and content of the MEPS Household and Medical Provider Surveys necessary to satisfy the congressional mandate to submit an annual report on national trends in health care quality. It also covers continuing costs for FY 2002 MEPS sample size and content enhancements necessary to prepare an annual report on health care disparities.
New Enhancements. An additional $1.0 million will be allocated for enhancements to the MEPS Insurance Component both in terms of sample size and improvements in the collection of information from employers about health insurance offerings and costs for their employees. The funds will support a 50 percent sample increase in the set of establishments associated with the MEPS household sample and data collection improvements to improve survey response rates. The enhancements will also permit more detailed analyses for population subgroups that include Asian and Pacific Islanders and individuals with incomes less than 200 percent of the poverty level.
Research Management: + $4,500,000
AHRQ requests $4,500,000 for research management costs. These funds will provide for current services, including annualization of the FY 2002 pay raise, the FY 2003 pay raise, and inflation. This request also includes $2,000,000 related to build-out costs for the consolidation of AHRQ's space, as well as $1,200,000 for relocation expenses to AHRQ's new building.
Accrued Retirement and Health Benefits Costs: + $86,000
The $1,700,000 in FY 2003 for accrued retirement and health benefits is an increase of $86,000 over the prior year. These funds are associated with the proposed Managerial Flexibility Act of 2001. This legislation requires agencies, beginning in FY 2003, to pay the full Government share of the accruing cost of retirement for current Civil Service Retirement System (CSRS), Central Intelligence Agency (CIA) and Foreign Service employees, and the Coast Guard, Public Health Service and National Oceanic and Atmospheric Administration Commissioned Corps.
The legislation also requires agencies to the pay full accruing cost of post-retirement health benefits for current civilian employees. The intention of the legislation is to budget and present the full costs of Federal employees in the accounts and programs where they are employed. This legislation is part of an initiative to link budget and management decisions to performance by showing the full cost of each year's program operations together with the output produced that year. These accrual costs are shown comparably in FY 2001 and FY 2002.
Non-Patient Safety Research and Training Grants: (- $66,404,000)
The FY 2003 request provides no funding for new non-patient safety research and training grants. AHRQ will fully fund grant commitments for our Translating Research Into Practice grants (TRIP) and our Consumer Assessment of Health Plans Survey (CAHPS®) grants.
Translating Research Into Practice (TRIP) is the final step of the research pipeline. This step focuses on closing the gap between what we know and what we do. The Agency is committed to informing practitioners, patients, consumers and other decisionmakers about needed health care changes as revealed by research. As we obtain the knowledge of what can be improved, the Agency must be able to promote the adoption and use of these research findings. By doing so, we will be better able to demonstrate that the benefits observed in research are achievable in daily practice and yield measurable and sustainable improvements in health care. TRIP grants will be funded at $7,000,000 in FY 2003.
CAHPS® is an easy-to-use kit of survey and report tools that provides reliable information to help consumers and purchasers assess and choose among health plans. Information from CAHPS® surveys was available to help more than 90 million Americans with their 2000 health care benefits decisions. There are CAHPS® data available to nearly 40 million Medicare beneficiaries on 280 plans. These beneficiaries received the assessment of beneficiaries enrolled in managed care plans. Data were provided in the handbook sent to each beneficiary and were placed on the Medicare.gov website. CAHPS® grants will be funded at $2,500,000 in FY 2003.
Other than patient safety, TRIP, and CAHPS® grant commitments, some combination of reductions will be made to ongoing grant commitments reflecting a decrease of $27,113,000. New non-patient safety research grants, including supplements, decrease a total of $39,291,000 from the FY 2002 level.
Non-Patient Safety Research Contracts: (- $6,641,000)
The FY 2003 request provides no funding for new non-patient safety research contracts. AHRQ will fully fund contract commitments for the Healthcare Cost and Utilization Project (HCUP) and for the contract component of CAHPS®.
HCUP is a Federal-State-industry partnership to build a standardized, multi-State health data system. This long-standing partnership has built and continues to develop and expand a family of administrative databases and powerful, user-friendly software to enhance the use of administrative data. Included in HCUP is hospital discharge information from State-specific hospital and ambulatory surgery databases, as well as a national sample of discharges from community hospitals.
HCUP data are used at all levels to inform decisionmaking. HCUP continues to be a very valuable resource in light of recent findings that about 40 percent of personal health care expenditures in the United States go towards hospital care—making it the most expensive component of the health care sector. HCUP is funded at $4,100,000 in FY 2003.
With the exception of the patient safety contracts, the contract component of CAHPS®, and the Healthcare Cost and Utilization Project (HCUP), some combination of reductions to non-patient safety contracts will be required reflecting a decrease of $6,641,000 for non-patient safety research contracts.
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For more information, contact:
Phone: (301) 594-6120
For more information, access the FY 2003 Budget Justification.
Current as of February 2002