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Dear Chair DeLauro and Ranking Member Cole:

The COVID-19 pandemic has clearly revealed stress fractures in the US healthcare system and that our nation’s goals of a system that ensures access to high quality healthcare for all is falling far short of its potential. We have seen the deep racial, ethnic, geographic, and socioeconomic health disparities and inequities both within and beyond healthcare as people of color have disproportionately contracted COVID-19, are suffering worse outcomes, having less access to diagnostics, vaccinations, treatments, and are dying at higher rates. At the same time, the federal government, states, localities, and health providers have taken dramatic actions to respond to the pandemic and other existing healthcare challenges, and they are being forced to do so without sufficient research and evaluations on the impacts of their decisions.

The Agency for Healthcare Research and Quality (AHRQ) supports research to improve health care quality, reduce costs, advance patient safety, decrease medical errors, and broaden access to essential services. As the lead federal agency for funding health services research (HSR) and primary care research (PCR), AHRQ is the bridge between cures and care, and ensures that Americans get the best health care at the best value. The RAND Corporation released a report in 2020 as called for by the Consolidated Appropriations Act of 2018, which identified AHRQ as “the only agency that has statutory authorizations to generate HSR and be the home for federal PCR, and the unique focus of its research portfolio on systems-based outcomes (e.g., making health care safer, higher quality, more accessible, equitable, and affordable) and approaches to implementing improvement across health care settings and populations in the United States.” AHRQ offers valuable insights on every facet of the health care system. For example, the National Academy of Sciences, Engineering and Medicine 2021 report on Implementing High Quality Primary Care highlighted the value of and need for federal investments in AHRQ through the National Center for Excellence in Primary Care Research.

While the vast majority of federally funded research focuses on one specific disease or organ system, AHRQ is the only federal agency that funds research at universities and other research institutions throughout the nation on health systems—the “real-life” patient who has complex comorbidities, the interoperability of different technological advances, and the interactions and intersections of health care providers. For example, some recent failures in the COVID-19 response can be addressed with more attention to the root causes of, and strategies for, addressing barriers to healthcare access, including what can be done in primary care to address health equity, and more broadly what are the patient-oriented primary care quality measures that would facilitate more engaged patient care.

As the lead agency for health services research and primary care research, AHRQ provides the resources that policymakers, health system leaders, medical providers, and patients need to determine the effectiveness of health systems delivery. In order to deliver better outcomes, we need to be able to differentiate which healthcare interventions work, for whom they work, and how to implement them, and HSR, PCR, and AHRQ are the process through which we develop that knowledge. For example, the effectiveness of a new vaccine is diminished if we do not have a robust and trustworthy delivery system that provides equitable access regardless of race, ethnicity, or income, and addressing questions like this is where AHRQ has a proven track record. Funding HSR and PCR through AHRQ is a key part of how we will best recover from COVID-19, prepare for the next pandemic, and address failures in the healthcare system that Americans continue to face.

The benefits of investing in health services research through AHRQ transcend the pandemic and provide benefits in saved lives, better value care, and improved patient outcomes across the health system. For example, the implementation of just one AHRQ-funded study on reducing hospital acquired conditions prevented an estimated 20,500 hospital deaths and saved $7.7 billion in health care costs from 2014 to 2017. To maximize the translation of research findings across the public health and health care continuum to improved patient care and keep pace with the rapidly evolving and changing health care landscape, additional investments in AHRQ are needed.

For these reasons, as you draft the Labor, Health and Human Services, Education, and Related Agencies appropriations legislation for fiscal year 2023, the 135 undersigned members of the Friends of AHRQ respectfully request no less than $500 million in funding for the Agency for Healthcare and Research and Quality (AHRQ). This request reflects an inflation adjustment from FY10 and the demonstrated need to expand and accelerate HSR investments to inform decision-making on the health care system as it recovers from the pandemic.

AHRQ is the federal vehicle for studying and improving the United States healthcare system, and it needs the resources to meet its mission and this moment. Through this appropriation level, AHRQ will be better able to fund the “last mile” of research from cure to care.

Thank you for your support of AHRQ and health services research. For more information, please contact Josh Caplan at [email protected]

 

Sincerely,

ABIM Foundation

Academic Pediatric Association

Academy of Medical-Surgical Nurses

AcademyHealth

ACCP

Alliance for Aging Research

Altarum

AMDA - The Society for Post-Acute and Long-Term Care Medicine

American Academy of Allergy, Asthma & Immunology

American Academy of Ambulatory Care Nurses (AAACN)

American Academy of Dermatology Association

American Academy of Family Physicians

American Academy of Hospice and Palliative Medicine

American Academy of Neurology

American Academy of Nursing

American Academy of Pediatrics

American Association for Clinical Chemistry

American Association for Dental, Oral, and Craniofacial Research

American Association for Physician Leadership

American Association for the Study of Liver Diseases

American Association of Colleges of Osteopathic Medicine

American Association of Colleges of Pharmacy

American Association of Occupation Health Nurses

American Association of Public Health Dentistry

American Association on Health and Disability

American Chiropractic Association

American College of Cardiology

American College of Nurse-Midwives

American College of Obstetricians and Gynecologists

American College of Physicians

American College of Rheumatology

American Health Information Management Association

American Health Quality Association

American Heart Association

American Medical Association

American Medical Student Association

American Nephrology Nurses Association

American Occupational Therapy Association

American Organization for Nursing Leadership

American Osteopathic Association

American Pediatric Society

American Physical Therapy Association

American Psychiatric Association

American Psychological Association

American Public Health Association

American Society for Nutrition

American Society for Transplantation and Cellular Therapy

American Society of Hematology

American Society of Nephrology

American Society of Pediatric Nephrology

American Society of Plastic Surgeons

American Statistical Association American Thoracic Society

American Urological Association

Arbor Research Collaborative for Health

Association for Clinical and Translational Science

Association for Prevention Teaching and Research

Association for Professionals in Infection Control and Epidemiology

Association of American Medical Colleges

Association of Departments of Family Medicine

Association of Family Medicine Residency Directors

Association of Maternal & Child Health Programs

Association of Medical School Pediatric Department Chairs

Association of Population Centers

Association of Schools and Programs of Public Health

Carnegie Mellon University

Case Western Reserve University School of Medicine

Cedars-Sinai

Clinical Research Forum

Coalition for Clinical and Translational Science

Columbia University Irving Medical Center

Consortium of Social Science Associations

Council of Medical Specialty Societies

Duke Health

EBQ Consulting, LLC

ECRI

Epilepsy Foundation

Federation of American Hospitals

Healthcare Information and Management Systems Society (HIMSS)

Healthy Teen Network

Heart Failure Society of America

Heart Rhythm Society

Johns Hopkins Health System

Kaiser Permanente

Lakeshore Foundation

Lown Institute

Lupus and Allied Diseases Association, Inc.

March of Dimes

Marshfield Clinic Health System

National Association of Nurse Practitioners in Women's Health

National Association of Pediatric Nurse Practitioners

National Athletic Trainers' Association

National Black Nurses Association

National Eczema Association

National Hispanic Medical Association

National League for Nursing

National Nurse-Led Care Consortium

National Organization of Health Data Organizations

North American Primary Care Research Group

Nurses Organization of Veterans Affairs

Oncology Nursing Society

Oregon Health & Science University

Pediatric Policy Council

Penn State Center for Health Care

Policy Research Population Association of America

Public Health Institute

Research!America Results for America

RTI International

Society for Healthcare Epidemiology of America

Society for Maternal-Fetal Medicine

Society for Participatory Medicine

Society for Pediatric Research

Society for Public Health Education

Society for Women’s Health Research

Society of Chairs of Academic Radiology Departments

Society of General Internal Medicine

Society of Hospital Medicine

Society of Teachers of Family Medicine

Society to Improve Diagnosis in Medicine

Spina Bifida Association

The American College of Preventive Medicine

The Cecil G. Sheps Center for Health Services Research

The Hilltop Institute at the University of Maryland,Baltimore County (UMBC)

The Leapfrog Group

The Society of Thoracic Surgeons

United Ostomy Associations of America

University of Michigan Institute for Healthcare Policy & Innovation

University of Oregon

University of Rocheste

University of Washington

UTHealth Houston

Vanderbilt University Medical Center

Washington State University

Weill Cornell Medicine