Issue Brief

September 2000

The Agency for Healthcare Research and Quality 

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What is AHRQ?
The mission of the Agency for Healthcare Research and Quality  is to support research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. The research that is sponsored, conducted, and disseminated by the agency provides information to assist persons in making better health care decisions.  Its research is designed to be used by healthcare professionals, healthcare system administrators, public policy decision-makers, patients, and consumers.

The AHRQ was previously named the Agency for Health Care Policy and Research (AHCPR), which was established in 1989 within the Public Health Service in the Department of Health and Human Services. It was created to help deal with critical national priorities in health care and research. Senator Durenberger and  Senator George Mitchell, were the chief sponsors.  The Senators created this agency because they believed medical practice needed to be informed, not just reimbursed.

The AHCPR was directed to provide objective science-based information that would improve decision-making at all levels. Among its early goals was the development and dissemination of clinical practice guidelines. This was viewed as an integral part of cost-containment strategies of many reform plans, including those of President Bush, the American Hospital Association and the Democratic Congressional leadership. It issued its first practice guidelines in early 1992 and in the beginning they were well received. However, within a few years the agency ran into serious conflict with some medical specialty groups and other providers. In 1996, the agency abandoned its efforts to establish clinical practice guidelines and spun off its program into three research programs – one to collect and synthesize published data for other organizations wanting to draft their own guidelines, another to monitor the development and use of guidelines, and a third program to develop a database of existing clinical practice guidelines.

After struggling for five years on annual appropriations without reauthorization, the AHCPR was finally reauthorized as the AHRQ by Congress in November of 1999.  In the process of that reauthorization, Congress made some important changes in the structure and mission of the agency.

The most obvious change was the name change. The purpose of the new name was to reaffirm the agency as a scientific research entity focused on improving quality in the healthcare system. Adding the word quality to the name makes clear that the agency is the lead federal agency on quality of care research. It has the responsibility to coordinate all federal quality improvement efforts and health services research.

The reauthorization revised the agency’s mission to emphasize its role as a partner to the private sector with responsibility for promoting health care quality. Further, even though the agency had ended its clinical guidelines program in 1996, Congress wanted to make it very clear that the agency was no longer in the business of promulgating clinical guidelines. The new agency has no regulatory responsibility.

In his testimony before the House Subcommittee on Health and Environment Dr. John Eisenberg summarized the role of the agency as follows: “…we are a science partner and work in collaboration with the public and private sector to build the science, knowledge and information that is going to help improve access, the quality and cost of care, and the functioning of the healthcare system in the United States.”

The 1999 law reaffirmed the agency’s earlier goals and research priorities and further directed the AHRQ to 1) improve the quality of healthcare, 2) promote patient safety and reduce medical errors, 3) advance the use of information technology for coordinating patient care and conducting quality outcomes research and 4) establish an office of priority populations. The purpose of this office is to ensure that the needs of those currently under-served in the healthcare system are addressed throughout the agency’s research portfolio.

The legislation to reauthorize the agency was authored by both Republicans and Democrats; it was moved through the Senate by unanimous consent and passed the House on a vote of 417 to 7. As Congressman Brown of Ohio noted on the House floor during the debate on this law, “The U.S. health care system is far from transparent. In fact, in many ways it is not even a system. It is a complex set of relationships influenced by science, demographics, politics, money and cultural trends…common sense alone rarely explains what is going on.” This agency, through its support of high-quality research, helps clinicians, patients, and public policymakers in better understanding what is going on.

For more extensive background on the AHRQ you may want to visit its web site at http://www.ahrq.gov/