Trump budget eliminates AHRQ, makes major cuts to OCR, ONC
President Trump on Monday released his proposed Fiscal Year 2019 budget for the Department of Health and Human Services, suggesting the elimination of funding for the Agency for Healthcare Research and Quality and slashing budgets for the Office of the National Coordinator for Health IT and HHS Office for Civil Rights.
Congress has traditionally ignored past White House budget proposals, but the plan does show the Trump administration‘s overall intentions for managing federal spending.
The FY 2019 HHS budget includes $256 million to consolidate the activities of AHRQ, which supports health services research addressing patient safety and healthcare quality as well as the application of HIT, into the National Institutes of Health—as the National Institute for Research on Safety and Quality (NIRSQ)—to eliminate duplication and redundancies.
“This consolidation will combine two agencies that both support health services research, and create an entity within NIH that can better coordinate and ensure a continued focus on research to improve healthcare quality and patient safety,” states the HHS budget document. “Within NIH, the FY 2019 budget includes $256 million in budget authority for NIRSQ to continue selected unique, systemically important activities formerly funded by AHRQ that have demonstrated effectiveness in improving healthcare quality.”
While AHRQ’s budget will be zeroed, according to the Administration’s budget justification, NIRSQ will continue projects to develop clinical decision support tools to bring electronic information to clinicians “at the right time to assist with making the right diagnosis” in an effort to reduce diagnostic errors.
“Additional projects are supporting the design of learning healthcare organizations that can collect and effectively utilize patient-reported outcome data for diagnostic decisions, and integrate findings to improve their daily work,” states the document.
When it comes to ONC, the FY 2019 budget for the agency is $38 million, $22 million less than the FY 2018 Continuing Resolution. To achieve this reduction, ONC will “continue the cost reductions included in the FY 2018 budget related to information technology, space, staff training and agency travel” and “continue to seek additional administrative and operational efficiencies.”
In FY 2019, ONC will focus on HIT interoperability and reducing provider burden, according to the budget document, which points out that “patient trust in the privacy and security of health data is a core requirement of an interoperable health system.” Towards that end, the agency will continue working with the HHS Office for Civil Rights to demonstrate how HIPAA and other privacy laws and regulations “support, rather than impede, information flow in an electronic environment.”
The budget request for OCR, which is responsible for enforcing the HIPAA privacy, security and breach notification rules, is $31 million in FY 2019—$8 million less than the FY 2018 Continuing Resolution level.
Nonetheless, the document states that “OCR will continue its robust and comprehensive HIPAA program efforts to maintain and improve upon the solid enforcement achievements from 2017.”