Online Performance Appendix: American Reinvestment and Recovery Act
Budget Estimates for Appropriations Committees, Fiscal Year 2010
The American Reinvestment and Recovery Act (ARRA) was signed into law by President Obama on February 17, 2009. It is an unprecedented effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century. The Act is an extraordinary response to a crisis unlike any other since the Great Depression, and includes measures to modernize our Nation's infrastructure, enhance energy independence, expand educational opportunities, preserve and improve affordable health care, provide tax relief, and protect those in greatest need.
ARRA contains $1.1 billion for comparative effectiveness research. Of the total, $300 million is for the Agency for Healthcare Research and Quality (AHRQ). Of the remaining funds, $400 million will be transferred to the National Institutes of Health (NIH), and $400 million will be allocated at the discretion of the HHS Secretary. The legislation calls on the Institute of Medicine to recommend research priorities for the Secretary's funds and gather stakeholder input. In addition, the Federal Coordinating Council for Comparative Effectiveness Research has been created to offer guidance and coordination on the use of these funds. Reports are due from both groups by June 30, 2009.
AHRQ is gearing up to make the most of this additional funding. We are undertaking a process to determine what will be funded. We are working closely with NIH and the Office of the Secretary to ensure that we use these funds in the most effective manner and that we are coordinating our plans to maximize effectiveness of this important investment.
AHRQ will use ARRA funds to expand and broaden comparative effectiveness research activities initiated at the Agency in response to Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, legislation designed to increase the availability of research that would inform the real-world decisions facing patients and clinicians. AHRQ's investments using ARRA funds will expand its Effective Health Care (EHC) Program. This effort will increase the national output of comparative effectiveness research; in addition, it may build research infrastructure and capacity, allowing future studies to address questions where data are currently not sufficient to provide guidance about competing alternatives and to improve the efficiency with which the research infrastructure is able to respond to pressing health care questions. Research activities will be performed using rigorous scientific methods within a previously established process that emphasizes stakeholder involvement and transparency, that was designed to prioritize among pressing health issues, and whose products are designed for maximum usefulness for health care decisionmakers.
More information on these and other ARRA programs can be found at http://www.hhs.gov/recovery.
Changes to Comparative Effectiveness Performance Measures Based on ARRA Funds
The existing measures currently used to report AHRQ's comparative effectiveness programs performance will be used. Performance measure targets and results will be adjusted to reflect ARRA funds once AHRQ's spend plan for comparative effectiveness funding for ARRA has been approved and announced to the public. We will report outcome and outputs, to the extent possible, supported with funding appropriated under ARRA as an incremental change from those supported by regular appropriations.
Changes to Performance Measures Based on ARRA Funds
| Measure | Most Recent Result | FY 2009 Target | FY 2010 Target | FY 2010 +/- FY 2009 |
|---|---|---|---|---|
1.3.24: Decrease mortality from and increase receipt of recommended care for subset of diseases measured and reported on in the National Health Care Quality Report1 (Developmental) (Interim Output) | FY 2008: Measures have been identified but a subset based on priority conditions has not yet been selected. (Target Met) | 1st and 2nd Qtr—Obtain baseline measures. 3rd and 4th Qtr—Set targets for FY 2010—2019 | N/A | N/A |
4.4.5: Increase # of systematic reviews (SR)) and summary guides (SG) produced per year1 (Outcome) | FY 2008: 7 SR; 12 SG (includes 2 SG translated into Spanish). (Target Met) | 10 SR 3rd and 4th Qtr—Set targets for FY 2010-2019 | TBD | TBD |
1.3.25: Increase # of organizations disseminating systematic reviews and summary guides to their constituents.1 (Output) | FY 2008: Have not completed identifying methods for systematically identifying organizations that are disseminating systematic review and summary guides. (Target Met) | 1st and 2nd Qtr—Obtain baseline data for this performance measure. 3rd and 4th Qtr—Set targets for FY 2010-2019 | N/A | N/A |
1.3.26: Increase amount of evidence from the Comparative Effectiveness (CE) Portfolio policymakers use as a foundation for population-based policies.1 (Interim Output) | FY 2008: Worked with Medicaid Medical Directors Learning Network to develop process for identifying how CE Portfolio products are used by these State clinical policymakers. (Target Met) | 1st and 2nd Qtr—Obtain baseline data for this performance measure. 3rd and 4th Qtr—Set targets for FY 2010-2019 | N/A | N/A |
| Program Level Funding ($ in millions) | $30 | $50 | $50 | 0 |
| ARRA Level Funding for AHRQ Comparative Effectiveness Research ($ in millions) | N/A | $300 | N/A | |
1. Targets for 2009 and 2010 will be adjusted to reflect ARRA funds once AHRQ's spend plan for comparative effectiveness funding for ARRA has been approved and announced to the public.
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