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Top HHS Official Makes Case for Threatened Research Agency

By Kerry Young, CQ Roll Call

October 5, 2015 --A top federal official on Monday made a case for preserving the little-known Agency for Healthcare Research and Quality, which focuses on improving the practice of medicine, and rejecting efforts by House Republican appropriators to terminate the agency in order to gain flexibility in a tight budget year.

“Your work is not a nicety, “Mary Wakefield, acting deputy secretary of the Department of Health and Human Services (HHS), said at a Monday agency conference attended by many of its staff members. “Your work is a necessity.”

Dismantling AHRQ would free up about $364 million for other programs funded by the annual Labor-HHS-Education funding bill (HR 3020). That makes the agency an attractive target for Republicans under pressure to both curb domestic spending and still boost the National Institutes of Health’s budget. In explaining their decision, GOP appropriators have said that AHRQ duplicates work done by other federal health agencies.

AHRQ officials and congressional Democrats in contrast argue that no other agency shares AHRQ’s focus in helping doctors and nurses disseminate information for how to better treat their patients. Much of its work involves developing procedures and checklists. These efforts don’t garner the same kind of media coverage as cutting-edge initiatives such as the White House’s Precision Medicine campaign, which is intended to make the most of recent rapid gains in genetic research.

AHRQ, for example, had seen hospital readmissions reduced by as much as 30 percent with tools it helped developed, Wakefield said. Its IDEAL program directs hospital staff to consult with people about to leave the hospital and their families about home life, review the medications that former patients will need to take on their own and alert them to warning signs of a relapse.

This is another form of personalized medicine, Wakefield said, using the term that has helped stir interest in the White House’s plan to advance the field of genetic research.

The agency has survived past efforts to kill or curtail it, former Senate Majority Leader Bill Frist, R-Tenn., wrote recently in Forbes, arguing against termination. A former top official in the administration of President George H.W. Bush, Gail Wilensky advocated for keeping AHRQ in a Sept. 30 article published in a forum for the Journal of the American Medical Association.

“Given the cost and the shortcomings of U.S. health care, it shouldn’t be difficult to recognize the need for an agency that focuses on strategies designed to advance evidenced-based treatments, to improve patient safety, to foster the use of health information technology in facilitating these goals, and to aid the dissemination of improved clinical care strategies,” said Wilensky, who led the predecessor agency to the Centers for Medicare and Medicaid Services in the early 1990s. “But apparently it is, as I’ve observed during the 40 years I have been in the field.”

Republican House appropriators have indicated that AHRQ could be spared if a new budget deal is struck to lift the caps for fiscal 2016. In the Senate’s Labor-HHS-Education bill (S 1695), appropriators keep the agency intact but would slash funding to $236 million while also giving the agency orders in the accompanying report to expand on its work in preventing misuse of antibiotics and aid with adoption of health technology.

“It will be an exciting year for AHRQ, assuming that our budget uncertainties are resolved,” said Richard Kronick, AHRQ’s director, at the Monday conference.

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