To: U.S. Senate Subcommittee on Labor, HHS, Education and Related Agencies Appropriations
From: AcademyHealth, 1150 17th Street NW Suite 600, Washington DC 20036
Re: FY 2014 Funding for Health Services Research & Health Data at AHRQ, NCHS, CMS, NIH
AcademyHealth is pleased to offer this testimony regarding the role of health services research in
improving our nation’s health and the performance of the health care and public health systems.
AcademyHealth’s mission is to support research that leads to accessible, high value, high-quality
health care; reduces disparities; and improves health. We represent the interests of more than
4,400 scientists and policy experts and 160 organizations that produce and use research to
improve health and health care. We advocate for the funding to support health services research;
a robust environment to produce this research; and its more widespread dissemination and use.
As medical research discovers for cures for disease, health services research discovers cures for
the health system. This research diagnoses problems in health care and public health delivery and
identifies solutions to improve outcomes for more people, at greater value. This research is used
by patients, health care providers, public health professionals, hospitals, employers, and public
and private payers to enhance consumer choice, improve patient safety, and promote high quality
care.
Finding new ways to get the most out of every health care dollar is critical to our nation’s longterm fiscal health. Like any corporation making sure it is developing and providing high quality
products, the federal government—as the nation’s largest health care purchaser—has a
responsibility to get the most value out of every taxpayer dollar it spends on Medicare, Medicaid,
Children’s Health Insurance Program, and veterans’ and service members’ health. Health
services research into the merits of different policy options for delivery system transformation,
patient-centered quality improvement, community health, and disease prevention offers
policymakers in both the public and private sectors the information they need to improve quality
and outcomes, identify waste, eliminate fraud, increase efficiency and value, and promote
personal choice.
Put plainly, health services research helps Americans get their money’s worth when it comes
health care. We need more of it, not less. Despite the positive impact health services research has
had on the U.S. health care system, and the potential for future improvements in quality and
value, the United States spends less than one cent of every health care dollar on this research;
research that can help Americans spend their health care dollars more wisely and make more
informed health care choices.
We respectfully ask that the subcommittee instead consider the value of health services research
and strengthen its capacity to address the pressing challenges America faces in providing access
to high-quality, efficient care. The following list summarizes AcademyHealth’s FY 2014 funding
recommendations for agencies that support health services research and health data under the
subcommittee’s jurisdiction.
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) is the federal health services research
agency with the sole purpose of improving health care. AHRQ funds health services research and
health care improvement programs in universities, medical centers, and research institutions that
are transforming people’s health in communities in every state around the nation. The science
funded by AHRQ provides consumers and their health care professionals with valuable evidence
to make health care decisions. For example, medical societies use AHRQ-funded research to
inform their recommendations for treatment of type 2 diabetes and rheumatoid arthritis. These
evidence-informed recommendations give physicians a foundation for describing what the best
care looks like, so millions of patients living with these and other conditions may determine what
the right care might be for them.
AHRQ’s research also provides the basis for protocols that prevent medical errors and reduce
hospital-acquired infections (HAI), and improve patient experiences and outcomes. For example,
AHRQ’s evidence-based Comprehensive Unit-based Safety Program to Prevent HealthcareAssociated Infections (CUSP)—first applied on a large scale in 2003 across more than 100 ICUs
across Michigan—saved more than 1,500 lives and nearly $200 million in the program's first 18
months. The protocols have since been expanded to hospitals in all 50 states, the District of
Columbia, and Puerto Rico to continue the national implementation of this approach for reducing
HAIs.
AcademyHealth joins the Friends of AHRQ—an alliance of health professional, research,
consumer, and employer organizations that support the agency—in recommending an overall
funding level of $434 million for AHRQ in FY 2014, consistent with the president’s request.
Centers for Disease Control and Prevention
The National Center for Health Statistics (NCHS) is the nation’s principal health statistics
agency. Housed within the Centers for Disease Control and Prevention (CDC), it provides
critical data on all aspects of our health care system through data cooperatives and surveys that
serve as a gold standard for data collection around the world. AcademyHealth appreciates the
subcommittee’s support of NCHS in recent years. Such efforts have allowed NCHS to reinstate
data collection and quality control efforts, continue the collection of vital statistics, and enhanced
the agency’s ability to modernize surveys to reflect changes in demography, geography, and
health delivery.
We join the Friends of NCHS—an alliance of health professional, research, consumer, industry,
and employer organizations that support the agency—in recommending an overall funding level
of $181.5 million for NCHS in FY 2014, consistent with the president’s request. This funding
will put the agency on track to become a fully functioning, 21st Century, national statistical
agency.
National Institutes of Health
NIH spends approximately $1 billion on health services research annually—roughly 3 percent of
its entire budget—making it the largest federal sponsor of health services research. We join the
research community in seeking at least $32 billion for NIH in FY 2014. NIH has an important
role in the federal health services research continuum, and is well-positioned to ensure that
discoveries from clinical trials are effectively translated into health care delivery.
AcademyHealth supports efforts to help NIH foster greater coordination of its health services
research investment among its institutes and across other federal agencies to avoid duplication.
AcademyHealth also recommends that the Clinical and Translational Science Awards (CTSA)
through the National Center for Advancing Translational Sciences (NCATS) sustain investment
in the full spectrum of translational research (T1-T4). The CTSA program enables innovative
research teams to speed discovery and advance science aimed at improving our nation's health.
The program encourages collaboration in solving complex health and research challenges and
finding ways to turn their discoveries into practical solutions for patients.
Centers for Medicare and Medicaid Services
Steady funding decreases for the Office of Research, Development and Information have
hindered CMS’s ability to meet its statutory requirements and conduct new research to
strengthen public insurance programs, which together cover nearly 100 million Americans and
comprise 45 percent of America’s total health expenditures. As these federal entitlement
programs continue to pose significant budget challenges for both federal and state governments,
it is critical that we adequately fund research to evaluate the programs’ efficiency and
effectiveness and seek ways to manage their projected spending growth. AcademyHealth
supports CMS’s discretionary research and development budget to improve the effectiveness and
efficiency of these programs.
In conclusion, the accomplishments of health services research would not be possible without the
leadership and support of this subcommittee. We hope the subcommittee gives strong
consideration to our FY 2014 funding recommendations for the federal agencies funding health
services research and health data. If you have questions or comments about this testimony or
wish to know more about health services research, please contact Lisa Simpson, President and
CEO of AcademyHealth, at 202.484.1100 or lisa.simpson@academyhealth.org.