Health research agency seeks more independence

A health policy research group, AcademyHealth, unveiled a framework aimed at updating how federal health evidence systems and the agencies overseeing them operate. Aaron Carroll, the organization’s president and CEO, discussed the proposed changes for the Agency for Healthcare Research and Quality (AHRQ) and related federal bodies.

Carroll discussed recent developments with AHRQ, including a ruling by the Government Accountability Office (GAO) that the impoundments sought by the government were illegal. This ruling has significant implications for the agency’s funding and operations.

Federal Health Research Agency Independence

According to Carroll, the GAO ruling highlights the need for stronger protections for federal health research agencies. The AcademyHealth blueprint recommends giving the heads of AHRQ and the National Center for Health Statistics (NCHS) fixed terms of office, statutory qualifications for the job, and removal only for cause.

Carroll emphasized that protecting the independence of research infrastructure is a key goal of the blueprint. This includes ensuring that agencies like AHRQ have the autonomy to conduct research without political interference.

The blueprint also recommends solidifying AHRQ’s role and bringing other groups, such as NCHS, under its umbrella. This would provide a single institutional home for health services research and core data functions.

Data Governance and Modernization

Carroll discussed the need for improved data governance and modernization in federal health research. The blueprint recommends giving the HHS chief data officer binding data governance authority for a core set of functions.

This would help to reduce redundancies, improve data consistency, and provide clearer authority for decision-making.

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Carroll noted that despite periodic investments in public health data infrastructure, there are still significant gaps in data collection, standardization, and funding. The blueprint recommends establishing national standards for data collection and ensuring that data is open and available by default.

The AcademyHealth blueprint also includes recommendations for the Center for Medicare and Medicaid Innovation (CMMI), including improved evaluation standards and increased transparency in data use. Carroll emphasized the need for CMMI to use more rigorous evaluation methods, similar to those used in other research fields.

Additionally, the blueprint recommends making the relationship between CMS and AHRQ more operational, so that evidence on treatments and procedures informs Medicare coverage decisions. Carroll highlighted the importance of ensuring that AHRQ assessments are non-biased and based on agreed-upon metrics.

Carroll cited the Rural Health Transformation Program as an example of how better evaluation and data use could lead to more effective policy decisions.

This would provide clarity and consistency in the production and use of evidence.

Implementing the Recommendations

Carroll noted that the current system for collecting and using public health data is often unorganized and unconnected. The federal government often relies on states to collect data, but this can lead to inconsistencies and gaps in funding.