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| United States Agency for Healthcare Research and Quality | |
|---|---|
| Name | United States Agency for Healthcare Research and Quality |
| Formed | 1989 |
| Preceding1 | Agency for Health Care Policy and Research |
| Jurisdiction | United States |
| Headquarters | Rockville, Maryland |
| Parent agency | United States Department of Health and Human Services |
United States Agency for Healthcare Research and Quality is a federal United States Department of Health and Human Services component created to improve the quality, safety, efficiency, and effectiveness of health care for Americans through evidence synthesis, data collection, and dissemination. The agency coordinates with entities such as Centers for Medicare and Medicaid Services, National Institutes of Health, Food and Drug Administration, Centers for Disease Control and Prevention, and academic institutions including Johns Hopkins University, Harvard University, and University of California, San Francisco to translate research into practice. It influences policy debates involving legislation like the Omnibus Budget Reconciliation Act of 1989, programmatic decisions in Medicare and Medicaid, and standards adopted by professional societies such as the American Medical Association and American Nurses Association.
The agency evolved from the Office of Medical Applications of Research and predecessor initiatives in the 1980s. Established under the Omnibus Budget Reconciliation Act of 1989, it succeeded the Agency for Health Care Policy and Research and later aligned with the Patient Protection and Affordable Care Act era priorities. Early collaborations involved the Institute of Medicine (now National Academy of Medicine), the Commonwealth Fund, and the Kaiser Family Foundation. Over time the agency expanded relationships with organizations including Agency for Toxic Substances and Disease Registry, Veterans Health Administration, State of Maryland, and academic centers such as Columbia University, University of Pennsylvania, University of Michigan, Duke University, and Yale University. Its history intersects with major events like the 1999 Institute of Medicine report To Err Is Human, policy shifts under Clinton administration, George W. Bush administration, Barack Obama, and Donald Trump administrations, and initiatives following the Affordable Care Act.
The agency is structured into centers and offices that interface with federal and nonfederal stakeholders including Congress committees, Government Accountability Office, and Office of Management and Budget. Leadership roles have included appointed directors who interact with cabinet-level officials in United States Cabinet meetings and testify before the United States House Committee on Energy and Commerce and the United States Senate Committee on Finance. Operational units collaborate with research networks such as the Patient-Centered Outcomes Research Institute, Agency for International Development, and academic consortia at Stanford University, Massachusetts Institute of Technology, University of Chicago, and University of California, Los Angeles. The agency’s offices coordinate workforce and training programs linked to associations like the Association of American Medical Colleges and National Rural Health Association.
Mandated to improve health care quality, the agency sponsors programs that produce evidence for stakeholders including physicians, nurses, pharmacists, health systems such as Mayo Clinic and Cleveland Clinic, and payers like Blue Cross Blue Shield Association. Core programs include comparative effectiveness research aligning with Patient-Centered Outcomes Research Institute priorities, patient safety initiatives inspired by Institute for Healthcare Improvement, and quality measures harmonized with National Quality Forum endorsements. Programs extend to rural care collaborations with Health Resources and Services Administration, behavioral health intersections with Substance Abuse and Mental Health Services Administration, and health IT projects tied to Office of the National Coordinator for Health Information Technology and Epic Systems Corporation implementations in hospital systems.
The agency produces systematic reviews, evidence reports, and data products such as the Healthcare Cost and Utilization Project and the Medical Expenditure Panel Survey. Publications inform clinical guidelines used by specialty societies like the American College of Cardiology, American Academy of Pediatrics, American College of Surgeons, American Psychiatric Association, and Society of Critical Care Medicine. Scholarly outputs appear in journals such as The New England Journal of Medicine, JAMA, The Lancet, BMJ, and Health Affairs. The agency collaborates on registries and trials with networks including ClinicalTrials.gov, All of Us Research Program, Veterans Affairs Cooperative Studies Program, and international partners such as the World Health Organization and Organisation for Economic Co-operation and Development.
Funding derives from congressional appropriations within the United States federal budget process and interactions with Office of Management and Budget allocations; supplemental funding occurs through interagency agreements with Centers for Medicare and Medicaid Services and grants to universities and nonprofits like the Robert Wood Johnson Foundation and Bill & Melinda Gates Foundation. Budgetary oversight involves reporting to Congressional Budget Office analyses, audit by the Government Accountability Office, and compliance with Federal Acquisition Regulation for contracting. Funding supports large datasets, grants to institutions such as University of Washington, University of Minnesota, Emory University, and cooperative research with private firms including IBM and Google health initiatives.
The agency’s work has influenced reductions in adverse events following recommendations from reports by Institute of Medicine and adoption of safety checklists used in World Health Organization surgical safety programs; outcomes affected include readmissions relevant to Hospital Readmissions Reduction Program metrics and quality measures endorsed by National Quality Forum. Criticisms address perceived politicization during different administrations, limitations in translating evidence into practice noted by National Academies of Sciences, Engineering, and Medicine reviews, debates over priority-setting relative to Patient-Centered Outcomes Research Institute and concerns about data transparency raised by Open Secrets and academic commentators at Brookings Institution and The Commonwealth Fund.
The agency partners with federal agencies including Centers for Medicare and Medicaid Services, National Institutes of Health, Centers for Disease Control and Prevention, Food and Drug Administration, and international bodies like the World Health Organization. Partnerships with academic centers such as Johns Hopkins University, Harvard University, University of California, San Francisco, and University of Michigan underpin training and research networks; collaboration with nonprofits like American Red Cross, Kaiser Family Foundation, Robert Wood Johnson Foundation, and The Commonwealth Fund supports dissemination. Initiatives span quality improvement collaboratives involving Mayo Clinic, Cleveland Clinic, Veterans Health Administration, and health IT interoperability projects tied to Office of the National Coordinator for Health Information Technology, major vendors like Epic Systems Corporation and Cerner Corporation, and standards organizations including Health Level Seven International.