Seizing the Opportunity to Improve Healthcare for All

Hello, friends. After many decades of admiring AHRQ—its mission, work, and people—I am deeply honored to lead this organization. I have devoted my career to advocating for a healthcare system that delivers everyone the best possible patient care. So today, it feels like nothing less than the opportunity of a lifetime to help guide the only agency with Congressional authority to use science to pursue equitable healthcare improvement.

It’s quite a goal we embrace here at AHRQ: to improve the safety and quality of healthcare for everyone. And yet, at this moment, and with solid support from the Biden Administration, I am convinced that this ambitious objective is precisely as it should be.

The COVID-19 pandemic underscored the urgent need to make healthcare safer, higher quality, more affordable, and equitable. The crisis revealed for all to see the inequities of our society reflected in how healthcare is organized, financed, and provided.

While the pandemic accelerated the adoption of important innovations, it also exposed inequalities in how these advances were made available in disadvantaged and rural communities.

For example, in New Mexico, where I lived before joining the Administration, telehealthcare was shown to work well for those with high-speed internet access. However, those living in remote rural and frontier communities with poor internet access were often stranded without adequate options for care.

Similarly, the Nation benefitted enormously from mRNA-based vaccines that were thankfully available first to millions of seniors in nursing homes and then to the general population after decades of development. But these life-saving protections were often unavailable to elderly African Americans and Latinos who primarily lived at home or with family. Moreover, many minority communities declined vaccinations because of persistent mistrust in the biomedical research enterprise.

These and other lessons suggest clear paths for our most urgent social improvement efforts. But to be successful, we must consider the roles of all who participate in today’s healthcare—not only physicians, nurses, and pharmacists, but also the many other medical professionals and non-clinical staff who are essential to the healthcare system enterprise. We must also re-ignite our relationships with social and behavioral scientists, pursuing an interdisciplinary approach necessary for systems change and professional acceptance of new knowledge.

Meanwhile, our focus on patient-centered care must evolve to recognize the traditional patient-health professional dyad where knowledge and experience dictate a successful encounter. I am delighted that we are deepening our understanding of the diverse societal factors that compromise patient well-being—limited access to healthy foods and exercise, caregiving challenges, stresses related to work and transportation, and the race and gender biases that pervade so many parts of everyday life.

At AHRQ, we view our goal as not to build a new normal but to build a better normal. And I am pleased that the Biden Administration’s proposed fiscal year 2023 budget would provide resources that support AHRQ’s mission and priority areas while taking great strides toward addressing the challenges revealed by the pandemic.

Overall, $415.9 million is requested in discretionary funds in FY 2023. That amount is $65.5 million more than allotted in FY 2022 and would continue to support current priorities. Among them:

• $62 million for investigator-initiated health services research.
• $10 million for research on opioids and polysubstance abuse prevention, management, recovery, and integration.
• $10 million on primary care research.
• $8 million on research to reduce diagnostic error.
• $7 million for maternal healthcare initiatives.

In addition, the President’s FY 2023 budget includes three new investments:

• $19 million to improve Long-COVID care.
• $5 million to create an all-payer claims database.
• $2 million to establish Centers of Excellence in Telehealth Implementation.

Finally, AHRQ is slated to receive $111 million in mandatory funds from the Patient-Centered Outcomes Research (PCOR) Trust Fund, increasing by $6 million from FY 2022. These investments support an exciting area of our work in 2023. We are currently seeking feedback on a draft strategic framework to guide AHRQ’s future investments in PCOR dissemination and implementation projects. Research findings must find their way into becoming innovative therapies rather than simply publications.

President Biden supports AHRQ’s mission to transform our healthcare system to serve all Americans with better care. Relying on our core competencies—health systems research, practice improvement, and data & analytics—I do not doubt that working together with our partners in the months ahead will achieve significant progress toward this vision.

Robert Valdez is director of AHRQ.

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