Executive Summary

Budget Estimates for Appropriations Committees, Fiscal Year 2010
This statement summarizes budget information submitted to Congress by the Agency for Healthcare Research and Quality (AHRQ).

A. Introduction and Mission

The U.S. health care system is considered by many to be the finest in the world. Americans are living longer, healthier lives, thanks to significant advances in biomedical and health services research. The translation of research findings into clinical practice has raised awareness of the importance of appropriate preventive services—such as timely screenings for cancer, heart disease, and other serious conditions—and the crucial role that maintaining a healthy lifestyle plays in maintaining health and enhancing quality of life.

However, our health care system faces many challenges: improving the quality and safety of health care, ensuring access to care, increasing value for health care, reducing disparities, increasing the use of health information technology, and finding new avenues for translating research into practice. We have made progress in meeting these challenges, but we can and must do better. Failure to improve health care delivery substantially is likely to impede realizing the full benefits of current breakthroughs in molecular medicine that can lead to personalized treatments.

As one of 12 agencies within the Department of Health and Human Services, the Agency for Healthcare Research and Quality (AHRQ) supports health services research initiatives that seek to improve the quality of health care in America. AHRQ's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The Agency works to fulfill this mission by conducting and supporting health services research, both within AHRQ as well as in leading academic institutions, hospitals, physicians' offices, health care systems, and many other settings across the country. The Agency has a broad research portfolio that touches on nearly every aspect of health care. AHRQ-supported researchers are working to answer questions about:

  • Clinical practice.
  • Outcomes of care and effectiveness.
  • Evidence-based medicine.
  • Primary care and care for priority populations.
  • Health care quality.
  • Patient safety/medical errors.
  • Organization and delivery of care and use of health care resources.
  • Health care costs and financing.
  • Health care system and public health preparedness.
  • Health information technology.

The ultimate goal is to disseminate AHRQ's research findings to produce healthier, more productive individuals and an enhanced return on the Nation's substantial investment in health care.

Return to Contents

B. Overview of AHRQ Budget

AHRQ's FY 2010 President's Budget Request level of $372,053,000 maintains the support provided by the FY 2009 Omnibus level. At this level AHRQ will support ongoing efforts to improve the quality, safety, outcomes, access to, and cost and utilization of health care services.

AHRQ has three budget activities: Research on Health Care Costs, Quality, and Outcomes (HCQO), the Medical Expenditure Panel Survey (MEPS), and Program Support (PS). The FY 2010 President's Budget Request for the HCQO budget activity totals $314,053,000, maintaining the FY 2009 Omnibus level. MEPS continues to provide the only national source for annual data on how Americans use and pay for medical care. The FY 2010 Request of $55,300,000 maintains the support provided at the FY 2009 level. Finally, Program Support is maintained at the FY 2009 Omnibus level of $2,700,000 to cover required costs related to the overall operation of the Agency.

Within the HCQO budget activity, AHRQ supports research related to five research priorities. These research portfolios include: Comparative Effectiveness, Prevention/Care Management, Value Research, Health Information Technology, and Patient Safety. In addition, AHRQ supports Crosscutting Activities Related to Quality, Effectiveness and Efficiency Research. Crosscutting Activities includes a variety of research projects that support all of our research portfolios. These activities include data collection and measurement, dissemination, rapid cycle research, training, research management and salary costs, and intramural and extramural research sponsored by multiple portfolios. The FY 2010 Performance Budget is displayed using these priorities.

Program increases:

HCQO: Crosscutting Activities Related to Quality, Effectiveness, and Efficiency—Research Management (+$2,478,000): In FY 2010, research management costs for AHRQ total $67,600,000, an increase of $2,478,000 from the prior year. The FY 2010 President's Budget Request level provides $1,872,000 for pay raise costs for AHRQ as a whole. An additional $606,000 is provided in FY 2010 for required research management increases within AHRQ's budget, including rent increases, travel, printing, and data costs.

Program decreases:

HCQO: Crosscutting Activities Related to Quality, Effectiveness, and Efficiency—Investigator-initiated Research Grants (-$2,478,000): The FY 2010 Estimate includes $37,124,000 (77 grants) in total research grants funds for HCQO: Crosscutting Activities Related to Quality, Effectiveness and Efficiency. This level provides a decrease of $2,478,000 from the FY 2009 level of $39,602,000—equivalent to a decrease of approximately 52 small, investigator-initiated research grants with an average cost of $50,000. The FY 2010 President's Budget Request will fund $6,421,000 in new investigator-initiated research grants, for a total of $23,551,000 in investigator-initiated research. This is a decrease of $2,478,000 from the FY 2009 funding level of $26,029,000 for investigator-initiated research grants.

FY 2009 American Recovery and Reinvestment Act (ARRA) Funding Comparative Effectiveness Research

In FY 2009, the American Recovery and Reinvestment Act (ARRA) provided $1,100,000,000 for Comparative Effectiveness Research. Of this total, $400,000,000 was transferred to the National Institutes of Health. A total of $400,000,000 is available for Comparative Effectiveness Research to be allocated at the discretion of the Secretary of the Department of Health and Human Services (HHS). A new Federal Coordinating Council for Comparative Effectiveness Research will help set the agenda for these funds.

The remaining $300,000,000 is available for the Agency for Healthcare Research and Quality (AHRQ) to conduct and support comparative effectiveness research. Comparative effectiveness research provides information on the relative strengths and weakness of various medical interventions. Such research will give clinicians and patients valid information to make decisions that will improve the performance of the U.S. health care system. AHRQ's comparative effectiveness research is related to the Department's Strategic Goal 1: Health Care: Improve the safety, quality, affordability, and accessibility of health care, including behavioral health care and long-term care.

Once the AHRQ Comparative Effectiveness Spend Plan has been approved by HHS, OMB and Congress, AHRQ will provide additional details of how the funding will be distributed.

Return to Contents

Discretionary All-Purpose Table

(Dollars in thousands)

Program FY 2008 Appropriations FY 2009 Omnibus FY 2009
Recovery Act1
FY 2010
President's Budget
Research on Health Costs, Quality and Outcomes (HCQO) Budget Authority $0 $0 $700,000 $0
Public Health Service (PHS) Evaluation 276,564 314,053 0 314,053
Subtotal, HCQO 276,564 314,053 700,000 314,053
Full Time Equivalents (FTEs) 278 278   316
Medical Expenditure Panel Survey (MEPS) Budget Authority 0 0 0 0
PHS Evaluation 55,300 55,300 0 55,300
Subtotal, MEPS 55,300 55,300 0 55,300
Program Support Budget Authority 0 0 0 0
PHS Evaluation 2,700 2,700 0 2,700
Subtotal, Program Support 2,700 2,700 0 2,700
FTEs 22 22 0 22
Subtotal Budget Authority 0 0 700,000 0
PHS Evaluation 334,564 372,053 0 372,053
Total Operational Level 334,564 372,053 700,000 372,053
FTEs 297 300   338

1 In FY 2009, the American Recovery and Reinvestment Act (ARRA) provided $1,100,000,000 for Comparative Effectiveness Research. Of this total, $400,000,000 was transferred to the National Institute of Health. A total of $400,000,000 is available for Comparative Effectiveness Research to be allocated at the discretion of the Secretary of the Department of Health and Human Services. A new Federal Coordinating Council for Comparative Effectiveness Research will help set the agenda for these funds. The remaining $300,000,000 is available for the AHRQ to conduct and support comparative effectiveness research. These funds are available for obligation in FY 2009 and FY 2010. The number of FTE in FY 2010 includes an estimated 38 non-permanent FTEs to be compensated using Recovery Act funds.

Return to Contents

Mechanism Tables

Total Agency for Healthcare Research and Quality (AHRQ)
Select HCQO and Other Portfolios
Patient Safety
Comparative Effectiveness

Mechanism Table—Total AHRQ

Mechanism Table Summary
(Dollars in Thousands)

Mechanism FY 2008
Actual*
FY 2009
Omnibus
FY 2009
Recovery Act
FY 2010
Budget Request
Number Dollars Number Dollars Number Dollars** Number Dollars
Research Grants Non-Competing 164 53,467 163 53,657     153 66,636
New & Competing 112 19,064 112 38,053     57 22,596
Supplemental   0   0   0   0
Total, Research Grants 277 72,531 275 91,710 0 TBD 210 89,232
Contracts and Inter-Agency Agreements (IAAs)   144,117   159,921       159,921
MEPS   55,300   55,300   0   55,300
Total Contracts/IAAs   199,417   215,221   TBD   215,221
Research Management   62,380   65,122       67,600
Total, AHRQ   334,328   372,053   300,000   372,053

*Reflects actual obligations not appropriated dollars.
**The American Recovery and Reinvestment Act (P.L. 111-5) included additional funding for AHRQ for comparative effectiveness research available in FYs 2009 and 2010. FY 2009 Recovery Act amounts will be provided once the spending plans are finalized.

Mechanism Table—Select HCQO Other Portfolios

Select HCQO and Other Portfolios1
(Dollars in Thousands)

Mechanism FY 2008
Actual2
FY 2009
Omnibus
FY 2009
Recovery Act
FY 2010
Budget Request
Number Dollars Number Dollars Number Dollars Number Dollars
Research Grants Non-Competing 105 29,243 88 27,622 0 0 74 32,083
New & Competing 73 6,912 59 16,080 0 0 21 8,421
Supplemental   0   0   0 0 0
Total, Research Grants 178 36,155 147 43,702 0 0 95 41,224
Contracts and Inter-Agency Agreements (IAAs)   71,559   64,220   0   64,220
MEPS   55,300   55,300   0   55,300
Total Contracts/IAAs   126,859   119,520   0   119,520
Research Management   62,380   65,122   0   67,600
Total, AHRQ   225,394   228,344   0   228,344

1Includes Value, Prevention/Care Management, Crosscutting Activities, MEPS and Program Support.
2Reflects actual obligations not appropriated dollars.

Mechanism Table—Patient Safety

Patient Safety Mechanism Table
(Dollars in Thousands)

Mechanism FY 2008
Actual1
FY 2009
Omnibus
FY 2009
Recovery Act
FY 2010
Budget Request
Number Dollars Number Dollars Number Dollars Number Dollars
Research Grants Non-Competing 60 24,224 72 25,588 0 0 52 21,333
New & Competing 34 9,655 26 9,920 0 0 36 14,175
Supplemental   0   0   0 0 0
Total, Research Grants 94 33,879 98 35,508 0 0 88 35,508
Contracts and IAAs   45,055   58,201   0   58,201
MEPS   0   0   0   0
Total Contracts/IAAs   45,055   58,201   0   58,201
Research Management   0   0   0   0
Total   78,934   93,709   0   93,709

1Reflects actual obligations not appropriated dollars.

Mechanism Table—Comparative Effectiveness

Comparative Effectiveness Mechanism Table
(Dollars in Thousands)

Mechanism FY 2008
Actual1
FY 2009
Omnibus
FY 2009
Recovery Act
FY 2010
Budget Request
Number Dollars Number Dollars Number Dollars2 Number Dollars
Research Grants Non-Competing 0 0 3 447     27 12,500
New & Competing 5 2,497 27 12,053     0 0
Supplemental   0   0   0 0 0
Total, Research Grants 5 2,497 30 12,500 0 TBD 27 12,500
Contracts and Inter-Agency Agreements (IAAs)   27,503   37,500       37,500
MEPS   0   0   0   0
Total Contracts/IAAs   27,503   37,500   TBD   37,500
Research Management   0   0       0
Total, AHRQ   30,000   50,000   300,000   50,000

1Reflects actual obligations not appropriated dollars.
2The American Recovery and Reinvestment Act (P.L. 111-5) included additional funding for AHRQ for comparative effectiveness research available in FYs 2009 and 2010. FY 2009 Recovery Act amounts will be provided once the spending plans are finalized.

Return to Contents
Proceed to Next Section

Internet Citation: Executive Summary. April 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/cpi/about/mission/budget/2010/web10sum.html