The Agency for Health Care Policy and Research would get a makeover and emerge as the Agency for Healthcare Quality under a bill introduced by Sen. William Frist (R-Tenn.). The bill language is also included in the Senate GOP managed-care regulation measure.
The new agency would coordinate the federal government's quality improvement efforts within the Public Health Service.
Frist, a heart and lung transplant surgeon, thinks the name change will give the agency a cleaner, more accessible public image and focus attention on the importance of healthcare quality.
The senator has been frustrated for a long time by physicians' inability or unwillingness to alter their practice patterns in light of recent research. He held hearings in April on ways to improve the information flow from the research community to practicing physicians.
His bill would also establish a new healthcare research foundation, which would foster public-private partnerships and attract private-sector money.
While focusing on quality, Frist's measure goes out of its way to state that although the federal government will help disseminate data, it will not dictate the practice of medicine.
"Nothing . . . shall be construed to imply that the agency's role is to mandate national standards of clinical practice or quality health standards," the measure states. Likewise, nothing should imply "that the agency's role is to mandate a national standard or specific approach to quality measurement and reporting. In research and quality improvement activities, the agency shall consider a wide range of choices, providers, healthcare delivery systems and individual preferences."
The AHCPR has a devoted following in the health services research community, but not necessarily among providers.
The agency caused an uproar a few years ago when it proposed practice guidelines that were objectionable to some medical specialists. Providers brought so much political pressure to bear that Congress nearly eliminated the agency.
The agency rapidly backtracked from the practice guidelines to save its neck.
Frist introduced his bill earlier this summer. It was subsequently incorporated into the Senate's healthcare bill to regulate HMOs. As part of that bill, it will come up for floor debate this month. But it still will be considered as a separate bill.
"It's fairly noncontroversial," said an aide to Frist. "We have not heard significant concerns."
David Kindig, M.D., past president of the Association for Health Services Research, said: "We're enormously pleased that Sen. Frist has taken the time to evaluate the AHCPR situation as carefully as he has. It's been a long time since we've had this level of concern and understanding. We're very supportive of the effort to reauthorize the agency and to go in the direction he wants to go."
The association has about 3,000 members who research healthcare cost, quality and access. Kindig's association is especially pleased to see funding rise to $180 million in the first year of the reauthorization. He hopes to see it go as high as $500 million by 2003, the final year of authorization. The bill does not address appropriations in 2003.
Kindig said that with all the biomedical advances coming through the Human Genome Project and National Institutes of Health, "without the kind of work that AHCPR does-evaluating cost, quality and access-those advances will not be available or appropriately used by the healthcare system. These things have to operate parallel."