Discontinued Performance Measures Tables (continued)

Performance Budget Submission for Congressional Justification, Fiscal

This appendix provides more detailed performance information for all HHS measures related to the Agency for Healthcare Research and Quality's budget.

Prevention

Long Term Goal: To translate evidence-based knowledge into current recommendations for clinical preventive services that are implemented as part of routine clinical practice to improve the health of all Americans.

MeasureFYTargetResult

Increase the quality and quantity of preventive services that are delivered in the clinical setting especially focusing on priority populations.

Outcome

2.3.1

2007

Develop tools to facilitate the implementation of clinical preventive services among multiple users

Completed:

Clinicians

  • Electronic Preventive Services Selector (ePSS) tool.
  • ACCTION PACK.

Health Insurance Purchasers

  • A Purchaser's Guide to Evidence-Based clinical Preventive Services: Moving Science into Coverage (Purchaser's Guide).

Consumers

  • 2 new evidence-based checklists.

2006

Establish baseline for reach of evidence-based preventive services though use of products and tools.�

Completed:

  1. Views and downloads of electronic content:
    • United States Preventive Services Task Force (USPSTF) recommendations: 4,242,074.
    • General Preventive services: 1,621,848.
    • National Guideline Clearinghouse™ related to USPSTF recommendations: 359,634.1
  2. Dissemination of published products:
    • 2005 Clinical Guide: 18,969.
    • Consumer products: 276,531.
    • Adult Preventive Care Timeline: Release in August 2006.
    • Journal publications:
      • Pediatrics, 2 publications, circulation 63,000.
      • Annals of Internal Medicine, 1 publication, circulation 92,756.

2005

Establish baseline quality and quantity of preventive services delivered.

Completed:

  • % of women (18+) who report having had a Pap smear within the past 3 years—81.3%.
  • % of men & women (50+) report they ever had a flexible sigmoidoscopy/colonoscopy—38.9%.
  • % of men & women (50+) who report they had a fecal occult blood test (FOBT) within the past 2 years—33%.
  • % of people (18+) who have had blood pressure measured within preceding 2 years and can state whether their blood pressure is normal or high—90.1%.
  • % of adults (18+) receiving cholesterol measurement within 5 years—67.0%.
  • % of smokers receiving advice to quit smoking—60.9%.

2004

Benchmark best practices for delivering clinical preventive services.

Completed: Expert opinions regarding best practices for delivering clinical preventive services obtained through stakeholder meetings and focus groups.

Increase continuing medical education (CME) activities by developing a Train the Trainer program for implementing a system to increase delivery of clinical preventive services.

Completed: Developed Train the Trainer program.

Improve the timeliness and responsiveness of the USPSTF to emerging needs in clinical prevention.

Outcome

2.3.2

2007

Decrease by 10% the number of USPSTF recommendations that are five years or older

Dec '07

Exceeded: As of January 1, 2007, 20 USPSTF topics were considered out of date by National Guidelines Clearinghouse™ standards.� By September 30, 2007, only sixteen topics should be out of date, representing a 20% decrease.

2006

Decrease the median time from topic assignment to recommendation release

Four topics released to date in FY 2006, time from assignment to release ranged from 14 to 30 months, median time 25 months.

2005

Establish baseline measures for timeliness and responsiveness.

Completed:

  • 9 recommendations released.
  • 78% current within National Guideline Clearinghouse™ standards (reviewed within 5 years).
  • 100% of recommendations related to Institute of Medicine (IOM) priority areas for preventive care current within National Guideline Clearinghouse™ standards.
  • Developed new topic criteria, submission, review, and prioritization processes with new USPSTF topic prioritization workgroup.

2004

N/A2

N/A2

Increase the number of partnerships that will adopt and promote evidence-based clinical prevention.

Outcome

2.3.3

2007

Three new partners will adopt and/or promote USPSTF-based tools

Dec-07

Exceeded:

  • Interagency Agreement (IAA) with Veterans Administration/National Center for Health Promotion & Disease Prevention.
  • Partnerships with the Veterans Administration and Dept of Defense (Air Force) distribution of USPSTF-based Adult Timeline prevention wall-charts to clinics.
  • Contract with National Business Group on Health for marketing and promotion of new Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage.
  • Addition of nurse practitioner and osteopathic professional organizations to the USPSTF Partnership group, resulting in active promotion of the USPSTF recommendations to these clinical provider audiences.

2006

Increase the number of partnerships promoting evidence-based clinical prevention by 5%

Completed:

AHRQ has an IAA with the Centers for Disease Control and Prevention (CDC) to support Steps to a Healthier US through technical assistance to Steps grantee communities to facilitate linkages between clinical prevention and public health efforts focused on healthy behaviors.

National Business Group on Health partnerships include development of Purchaser's Guide to Clinical Preventive Services (including coverage for colorectal cancer screening), and an assessment of the integration of employer supported prevention efforts.

In partnership with Administration on Aging, CDC, and National Council on Aging,� support a project to assist community dwelling older adults maintain independent living through evidence-based disease and disability prevention and early detection. AHRQ is supporting linkages between clinical providers and aging social services and public health programs.

2005

Establish baseline partnerships within the Prevention Portfolio promoting clinical prevention

Federal partners—10

Non-Federal partners:

  • 10 Primary Care Organizations.
  • 2 Health Care Insurance Industry.
  • 2 Consumer Organization.
  • 3 Employer Organizations.
  • 6 Other organizations.

2004

Produce fact sheets for adolescents, seniors, and children.� Partner with appropriate professional societies and advocacy groups

Completed:

  • Pocket Guide to Staying Healthy at 50+—revised Nov. 2003 (English and Spanish)—AARP Partnership.
  • Adult health timeline (for clinicians/patients)—revised Jan. 2004.
  • Women: Stay Healthy at Any Age—printed Jan. 2004 (English and Spanish).
  • Men: Stay Healthy at Any Age—printed Feb. 2004 (English and Spanish).
  • Pocket Guide to Good Health for Children—revised May 2004 (English and Spanish).

Data Source: National Health Quality Report (NHQR); National Healthcare Disparities Report (NHDR); AHRQ—USPSTF/Preventive Services Web site; AHRQ product distribution process; AHRQ Preventive services databases (internal); Web trends; AHRQ Publications Clearinghouse; National Guideline Clearinghouse™;� electronic Preventive Services Selector; Evidence-based Practice Center task order documents; Action Network contracts

Data Validation: Because the Prevention Portfolio cannot collect primary quantitative data regarding healthcare service delivery or quality, it relies on federal partners and federal public release data sources for these measures, which include the National Health Quality Report and National Healthcare Disparities Report. As legislated by Congress, AHRQ produces these reports annually. Data comprising the reports are drawn from multiple databases (e.g., the Medical Expenditure Panel Survey [MEPS], the Healthcare Cost & Utilization Project [HCUP], Consumer Assessment of Healthcare Providers and Systems [CAHPS®]) supported by AHRQ, in addition to other databases (such as the National Health Interview Survey [NHIS], supported by CDC). These reports and the databases from which they are drawn are considered definitive sources of healthcare quality measures. Other data sources (qualitative): Stakeholder meetings, expert panel meetings, and focus groups. Qualitative data were gathered primarily by outside contractors. The information obtained was analyzed, synthesized and reported using established methodology. Because of the limitations of qualitative data with respect to validity, the results obtained from these sources were used to identify successful case studies, themes, and areas for future opportunity. Other data sources (internal): Database established to monitor the timeliness of current recommendations. Database established in 2006 to track partnership development and collaborative activities with public and private organizations.

Cross Reference: HHS Goals and Objectives: 2.3; HP2010-13/14/15/16/18/19/21/22/24/25/27; HHS Priorities: Prevention.

Care Management

Long Term Goal: Increase the delivery of evidence-based treatments for acute and chronic conditions, through research and research syntheses; development of tools; identification of effective implementation strategies; and promotion of effective policies.

MeasureFYTargetResult

By 2010, we will:

  • Increase by 15% the proportion of patients with diabetes, coronary heart disease (including acute myocardial infarction) and asthma who receive effective treatments.
  • Reduce disparities in effective care delivered to different populations. (Developmental).
  • Increase the proportion of patients with chronic conditions such as diabetes and asthma who practice self-care. (Developmental).
  • Increase the proportion of clinicians who have access to evidence-based tools to guide treatment decisions. (Developmental).

Outcome

1.3.14

2007

Complete 2 reports under MMA Section 1013 to inform pharmacy benefits relevant to chronic disease. Establish survey measures for patient self-management of chronic disease.

Completed

2006

Begin interventions through partnerships with Federal and State agencies, professional societies, plans and purchasers.

Completed

2005

Develop partnerships with 2-4 large delivery systems (States, health plans, purchasers) to improve outcomes and reduce disparities for 1 to 3 specific chronic diseases.

Completed

2005

Synthesize evidence on interventions, burden of disease, gaps in care and costs; agree on outcome measures to be tracked.

Completed

2005

Establish trends in National Quality Report categories

Completed

2004

Report on progress in core measure set in National Quality Report and National Disparities Report.

Completed

2004

Identify private sector data to be used in future reports.

Completed

2004

Synthesize evidence on interventions on improving diabetes and hypertension care.

Completed

Data Source: National Health Care Quality Report; National Healthcare Disparities Report; RFC Healthplan Disparities Collaboratives; Effective Healthcare Program reports

Data Validation: Measures in the NHQR and NHDR are based on validated surveys conducted by HHS Agencies including AHRQ and CDC and private partners such as the National Committee for Quality Assurance (NCQA).

Cross Reference: HHS Goals and Objectives: 1.3; HP2010-3/4/5/12/13/14/16/21/24; HHS Priorities: Value-Driven Health Care

Cost, Organization, and Socio-Economics

Long Term Goal: By 2010, in at least 5 cases, public or private health care policymakers and decisionmakers will have used AHRQ findings or tools in the area of:

MeasureFYTargetResult

System and delivery improvement, payment and purchasers, and/or market forces to make decisions designed to improve quality, effectiveness, and/or efficiency of health care by 5%.

Outcome

Financing, access, costs, and coverage to make decisions designed to improve the efficiency of the U.S. health care system while maintaining or improving quality, and/or improving access to care or reducing any existing disparities.

Outcome

1.2.1

2007

Develop an evaluation of efficiency measures, including a useful applied taxonomy, an evaluation of the current published measures and a broad assessment of use.

Dec-07 

2007

Conduct or support 15 new projects on research related to financing, access, costs, coverage, delivery, payment, purchasing of market forces that are disseminated to health care policymakers and healthcare decisionmakers.

Dec-07

2006

Develop and enhance mechanisms to disseminate and assist with implementation of findings to health care public policymakers, systems leadership, purchasers/employers, and health services researchers.

Completed: Held conference to present research findings to policymakers

Conduct or support 15 new projects on research related to financing, access, costs, or coverage that is disseminated to health care policymakers.

Completed

2005

Conduct or support 12 new projects related to system and delivery improvement, payment and purchasers, and/or market forces.

Completed

2005

Conduct or support 15 new projects related to financing, access, cost, or coverage.

Completed

2005

Complete a synthesis of research in a significant area or system and delivery improvement, payment and purchasers, and/or market forces.

Completed

2005

Complete a synthesis of research in a significant area of financing, access, cost, or coverage.

Completed

2004

Develop a data warehouse and vocabulary server to process patient safety event data

Completed

Data Source: Publications, intramural plans for the Center for Financing, Access and Cost Trends (CFACT) and Center for Delivery, Organization, and Markets (CDOM), grants management tracking of funded projects, and tracking of all deliverables by the Integrated Delivery System Research Network (IDSRN) project officer.

Data Validation: The CFACT and CDOM intramural plans are maintained and reviewed by senior staff. Grants are monitored by project staff, and the IDSRN has a senior project officer.

Cross Reference: SG-1.2, 4.4;HP2010-17; 500-Day Plan—Value Drive Health Care

Training

Long Term Goal: By 2010, enhance capacity to conduct and translate health services research (HSR) by:

MeasureFYTargetResult

Increase the number of individuals who receive career development support by 30%.

Outcome

4.1.1

2007

Increase by 15% from FY 2004

9 new grants awarded

2006

Increase by 10% from FY 2004

15 new grants awarded

2005

Increase by 5% from FY 2004

2 new awards (Career development budget was reprogrammed in FY 2005)

2004

Support 40 career development grants

49

Improve geographic diversity by increasing the number of States by 5 which have the capacity to undertake HSR.

Increase the number of institutions serving predominantly minority populations by 5 which have the capacity to undertake HSR.

Output

4.1.2

2007

Support at least 2 new programs

Dec-07

Expected to meet pending review completion and funds availability, data not yet available

2006

Issue new announcement

11 new awards were issued

2005

Support at least 3 institutions in new States and at least 1 new predominantly minority serving institution

No new awards due to reprogramming of FY 2005 Building Research Infrastructure and Capacity (BRIC) funds

2004

Baseline—support 6 institutions in new States and 9 predominantly minority-serving institutions

Completed

Support 5 institutional programs that develop HSR curricula to address safety/quality, effectiveness, and efficiency

Output

4.1.3

2007

Support at least one new project

Completed: 2 awards made

2006

Issue announcement

Presentation at annual meeting of Academy Health and AHRQ National Research Service Award (NRSA) Trainee Conference, followed by journal publication

2005

Support one pilot project leading to development of cultural competencies in HSR doctoral training

Completed 2 projects: small pilot feasibility study and related conference "HSR competencies for Doctoral Training"

2004

N/A

N/A

Data Source: IMPAC II

Data Validation: AHRQ budget data management system used to keep annual track of spending relative to budget allotment

Cross Reference: HHS Strategic Goal and Objective: 4.1; Departmental Objective:16; HP2010-23; HHS Priorities: Value-Driven Health Care and Personalized Health Care

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Current as of February 2008
Internet Citation: Discontinued Performance Measures Tables (continued): Performance Budget Submission for Congressional Justification, Fiscal . February 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/mission/budget/2009/opa11.html