Senate Spending Bill Cuts AHRQ Budget, Includes Focus on Telehealth for Rural Health Care

June 11, 2016
The Senate Committee on Appropriations approved for Senate consideration a bipartisan spending bill that, while increasing funding for healthcare research and programs to combat the opioid abuse crisis, cuts or maintains funding for health IT-related agencies.

The Senate Committee on Appropriations approved for Senate consideration a bipartisan spending bill that, while increasing funding for healthcare research and programs to combat the opioid abuse crisis, cuts or maintains funding for health IT-related agencies.

The FY2017 Labor, Health and Human Services, and Education and Related Agencies (Labor-HHS) Appropriations Bill provides a $2 billion increase for medical research by the National Institutes of Health (NIH), $261 million to combat the opioid abuse crisis and $152.6 million, an increase of $3 million above 2016, for rural health programs. The $2 billion increase for NIH is to help advance research on precision medicine, Alzheimer’s disease, the BRAIN Initiative and other ailments, according to the Senate committee.

“This is the first bipartisan Senate Labor-HHS bill in seven years, and I want to thank Senator Murray for her work on this bill. The fiscal year 2017 Labor-HHS bill eliminates more than a dozen duplicitous or unnecessary funding programs in addition to the 18 from last year’s bill, and is $270 million less than last year,” U.S. Senator Roy Blunt (R-Mo.) said in a statement.

However, the spending bill cuts funding for the HHS Agency for Healthcare Research and Quality (AHRQ) by $10 million to $324 million. Last year, AHRQ saw its 2015 budget of $364 million cut by about 8 percent.

Last June, the House Appropriations Committee voted in favor of a bill that would eliminate the AHRQ all together. As reported by Healthcare Informatics last year, the research agency has long been disliked by some members of Congress who feel that the organization's work has not led to proven results. However, the White House had asked for funding of the AHRQ, which has areas devoted to health IT research, to remain static.

The Senate Committee spending bill recommends maintaining the same level of funding for the Office of the National Coordinator for Health Information Technology (ONC) at $60 million as well as for the Office for Civil Rights (OCR) at $28 million. OCR is responsible for enforcing civil rights-related statutes in healthcare.

And, aside from funding, the bill also continues a provision “prohibiting the use of funds to promulgate regulations regarding the individual health identifier,” which refers to legislation that was passed back in 1999 prohibiting the HHS from spending public funds on the development of a national patient identifier.

The spending bill directs the Health Resources and Services Administration (HRSA) within HHS to develop a plan to create a telehealth center of excellence (COE) to test the efficacy of telehealth services in both urban and rural geographic locations. The COE would operate varied sties of service, including patients’ homes, establish standards and best practices for various telehealth modes of delivery and pilot new healthcare delivery models as they emerge, according to the spending bill. And, the bill recommends HHS consider a public academic medical center with demonstrated success, a high volume of annual telehealth visits and established programs that provide telehealth services in medically underserved areas with high chronic disease prevalence and high poverty rates.

The Senate Committee also focused on rural health care in the spending bill, as the Office of Rural Health Policy will receive $152.6 million in funding, an increase of $3 million above fiscal year 2016, for rural health programs, including for telehealth programs.

“The obstacles faced by patients and providers in rural communities are unique and often significantly different than those in urban areas.  Therefore, the bill focuses resources toward efforts and programs to help rural communities, such as telehealth,” the bill stated.

Specifically, the appropriations bill provides $18 million in funding, up $1 million from last year, to the Office for the Advancement of Telehealth, which promotes the effective use of technologies to improve access to health services for people who are isolated from healthcare.

And, the Senate Committee directs the Office of Rural Health Policy to explore how telehealth networks can improve access to, coordination of, and quality of prevention and treatment of the opioid epidemic, especially in rural areas

And, as previously reported by HCI, Senators Orrin Hatch (R-Utah) and Brian Schatz (D-Hawaii) have introduced the Expanding Capacity for Health Outcomes (ECHO) Act with the aim of expanding New Mexico’s Project ECHO as a national model for using telehealth for rural care.

The Senate spending bill requests a report from the Government Accountability Office regarding opportunities for increased adoption of such models, efficiencies, and potential cost savings, as well as ways to improve health care through such models, and field recommendations to advance the use of such models.

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