In 1989, Congress set up the Agency for Health Care Policy and Research, which was reauthorized (and renamed) as the Agency for Healthcare Research and Quality (AHRQ) in 1999. The stated purpose of the Agency was “to enhance the quality, appropriateness, and effectiveness of health services, and access to such services, through the establishment of a broad base of scientific research and through the promotion of improvements in clinical and health system practices, including the prevention of diseases and other health conditions.”
With such an important mission—and at a time when policymakers from both sides of the aisle are calling for more evidence-based decisionmaking—the health services research community was taken aback when, earlier this year, the House Appropriations Committee approved a proposed spending bill that eliminated funding for AHRQ and the Senate, in its version of the bill, cut the agency's budget by 35 percent.
As questions have arisen about the future of AHRQ, we took stock of how AHRQ data and research affect our work. We found that AHRQ data and research have been used in scores, if not hundreds of briefs, reports and peer-reviewed articles produced by Urban Institute researchers over the years. AHRQ data and research form the bedrock of HIPSM, our microsimulation model, which we have used to simulate the effects of the Affordable Care Act and other health reform proposals. These data are also central to our research on preventive care receipt, health care spending trends and patterns, uncompensated care, costs of employer-sponsored insurance for dependents, out-of-pocket spending on health care, paid sick leave, and prescription drug spending.
Recent examples of prominent Urban Institute research have relied heavily on AHRQ data. Without the data and research from AHRQ, our analyses of important policy questions related to Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act would have been seriously hampered.
While other data sources are available to track health care spending and health insurance plans offered by employers, our model is benchmarked to the AHRQ data, which remain the gold standard. Citations to AHRQ research are also found in almost all Urban Institute publications on these topics. And beyond our use of AHRQ data and research, we regularly look to and collaborate with AHRQ researchers as resources for their deep knowledge of health data, methods, and policy issues.
Given the impact that AHRQ has had on Urban’s research and the work we have seen from other research organizations and universities, it is hard to overstate the critical role that AHRQ plays is shaping the field of health policy and health services research. The agency’s research focuses on interventions in real communities affected by the issues that health reform seeks to address. While clinical trials through organizations such as NIH are an indispensable method in the research toolbox, understanding how health care policies and demonstrations operate in practice is critical to a safer, more accessible, and higher quality health care system.