June 6, 2006

Dear Chairman Specter and Senator Harkin:

As you prepare to mark up the FY 2007 Labor, Health and Human Services, Education and Related Agencies appropriation bill, the undersigned members of the Friends of AHRQ stress the important role the Agency for Healthcare Research and Quality (AHRQ) plays in the American healthcare system and urge you to increase funding for AHRQ to at least $440 million. With healthcare costs on the rise each year, and a growing emphasis on consumer empowerment in healthcare decision-making, the case for AHRQ research has never been more compelling.

AHRQ is lead agency for primary care research and health services research-a field of scientific study that explores healthcare costs, quality, and access and seeks ways to improve healthcare delivery, safety, availability, and affordability from birth through end of life. AHRQ's sponsored research identifies what treatments work best when, for whom, and at what sites of service. It also evaluates how best to finance healthcare and control spending. AHRQ takes the innovations from basic bench science and produces understandable, practical materials for patients, providers, health plans, and policymakers, allowing them to make more rational, informed health choices . In sum, AHRQ is the link between research and the patient care that Americans receive.

The President's budget request for AHRQ in FY 2007 is $319 million, the same as for FY 2005 and FY 2006. While we appreciate the support the Administration has shown for the agency in the past, AHRQ's ability to fund new research has been strained because its budget has not kept pace with inflation. Specifically, AHRQ has been forced to restrict new grant approvals to $300,000 per year (including indirect costs) and dramatically curtail the number of new and competing grants from 168 grants in FY 2004 to 91 in FY 2006. This lack of growth has all but eliminated investigator-initiated research at AHRQ, compromising the advancement of innovative health services research and deterring new investigators from entering the field.

For this and other reasons, the Friends of AHRQ support a total appropriation of $440 million for FY 2007, which represents an increase of $121 million over the FY 2006 appropriation of $319 million. This is a large increase for any one agency, but a small increase when compared with overall federal health research spending of $35 billion . An increase of $121 million would allow AHRQ to:

• Invest an additional $60 million in comparative effectiveness research for children and adults-where drugs, devices, and therapies used to treat the same conditions are evaluated for their relative safety, effectiveness, and cost. Comparative effectiveness research has great potential to improve health care quality and patient outcomes, while ensuring that consumers, both patients and purchasers, receive the best care at the best value. Congress authorized these federal evaluations of pharmaceuticals and medical technologies through Section 1013 of the Medicare Modernization Act; in the last two years, only $15 million per year has been appropriated to AHRQ to conduct these important studies.

• Increase funding for health care financing research by $20 million . With health care spending continually on the rise, a greater amount of research is needed to identify new and innovative financing strategies for improving health quality and efficiency.

• Devote an additional $16 million to studying medical errors and patient safety, bringing overall funding for this research up to $100 million, as recommended by the Institute of Medicine 's report, To Err is Human .

• Add $10 million in new funds devoted strictly to research on health information technology . AHRQ is currently provided with $50 million in health information technology money, all of which comes from the patient safety budget.

• Dedicate an additional $7 million to support data systems . Without timely and accurate data, there would be no health services research and no new knowledge to inform important healthcare decisions, including those in policy spheres. Greater resources are needed to collect, maintain, and disseminate data to researchers, policymakers, providers, patients, and others.

We believe that the priorities outlined above are needed to develop a robust health services research program in the United States, which will lead to improved health care for all citizens. We would greatly appreciate your support for $440 million in FY 2007 for AHRQ funding.

If you have any questions, please contact Emily Holubowich, Director of Government Relations for the Coalition for Health Services Research at either (202) 292-6743 or emily.Holubowich@academyhealth.org. Ms. Holubowich coordinates the activities of the Friends of the AHRQ.

Sincerely,

Alliance for Aging Research
Ambulatory Pediatric Association
American Academy of Family Physicians
American Academy of Pediatrics
American Association for Clinical Chemistry
American Association of Colleges of Nursing
American Association of Colleges of Pharmacy
American Association for Dental Research
American Association for Geriatric Psychiatry
American Association of Orthopaedic Surgeons
American College of Cardiology
American College of Preventive Medicine
American Dental Association
American Dental Education Association
American Geriatrics Society
American Heart Association
American Medical Association
American Nurses Association
American Osteopathic Association
American Pediatric Society
American Physical Therapy Association
Association of American Medical Colleges
Association of Departments of Family Medicine
Association of Family Medicine Residency Directors
Association of Medical School Pediatric Department Chairs
Association of Minority Health Professions Schools
Asthma & Allergy Foundation of America
Coalition for American Trauma Care
Coalition for Health Funding
Coalition for Health Services Research
Friends of the National Institute on Aging
Kaiser Permanente
Medical Library Association/Association of Academic Health Science Libraries
National Business Coalition on Health
National Business Group on Health
North American Primary Care Research Group
Research! America
RTI International
Society of General Internal Medicine
Society of Hospital Medicine
Society for Pediatric Research
Society of Teachers of Family Medicine
Society of Thoracic Surgeons