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Absorbing Quality Management with a Magic Wand

Written by: Darlene D'Altorio-Jones (1959-2015) on Wednesday, February 6, 2013 Posted in: Acute Care Rehab

Each year in February the President submits a budget for the next fiscal year.  There are 12 different appropriations to that budget and both the House and Senate Appropriations Committees are to write and recommend their versions.  This is the first time in six years that the House has completed and voted on a recommended draft budget for Labor, Health & Human Services and Education.  The vote on the draft was approved 30-21.   Of course the bills then need approval by midnight September 30th, 2015 or the agencies shut down.  This is by no means a done deal but I thought it was worthy of discussion.

What I found exceptionally remarkable is that now more then ever when outcomes, transparency, performance and payment are all relying on a new platform called ‘QUALITY’ as a primary facilitator of change the House’s Draft Appropriations Bill has decided that the Agency for Healthcare Research and Quality, (AHRQ), a division under Health and Human Services can be written TOTALLY out of the budget.  Their work can be absorbed by ‘duplicative’ agencies.

All agencies provide the committees with documentation and recommendations for the support of their budget outlining past performance, accomplishments, savings etc.  Despite AHRQ’s 86 page proposed budget to justify the 2016 spending amounts; they got nothing!

The full committee report states this on page 4:

“REDUCTIONS AND TERMINATIONS:  In preparing this bill, the Committee scrutinized existing programs and activities to determine which ones could be eliminated in order to reduce unnecessary spending and duplicative programs. As a result, this bill terminates 26 programs and activities which are narrowly targeted toward a small audience or do not represent a clear Federal role. The bill also consolidates duplicative efforts as it merges the Agency for Healthcare Research and Quality (AHRQ) into existing HHS agencies. The AHRQ mission and areas of research also exist in other HHS agencies. The Committee therefore includes bill language to consolidate these research activities into other agencies in a more efficient and effective way to meet the missions of both AHRQ and HHS. Specifically, the language provides the Secretary with transfer authority to use funds from across the HHS to fund the orderly termination of AHRQ. It also allows the National Institutes of Health, the Centers for Disease Control and Prevention, the Office of the National Coordinator for Health Information Technology, and Office of the Assistant Secretary for Health to incorporate the AHRQ activities each determines to support its mission, within its existing authority. In addition, the language transfers the Prevention Public Health Task Force to the Office of the Assistant Secretary for Health.”

Duplicative for how many years? Can an entire agency be ‘orderly terminated’ and still function within the scope of their accomplishments under a sister agency?  I can’t pretend to have those answers but somehow the House Appropriations Committee believes it is possible.  Quality vs. Quantity – wasn’t that the new order of business?  Will this House draft be supported in the long run?  You’re in health care, perhaps you should let your representative know how this makes you feel when it comes up for a full vote.  Can you support that budget recommendation?


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