[Congressional Record Volume 142, Number 69 (Thursday, May 16, 1996)]
[Extensions of Remarks]
[Pages E836-E837]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH

                                 ______


                         HON. WILLIAM M. THOMAS

                             of california

                    in the house of representatives

                         Thursday, May 16, 1996

  Mr. THOMAS. Mr. Speaker, as the chairman of the Ways and Means Health 
Subcommittee, I want to take this opportunity to comment on the Budget 
Committee's report language relating to the Agency for Health Care 
Policy and Research [AHCPR] that was included with its discussion of 
the major discretionary health programs funded under function 550. The 
report language refers to the committee's objections to AHCPR's role in 
the development of outcomes research-based clinical practice guidelines 
and the need to better integrate survey and data collection efforts at 
a number of agencies, including AHCPR. This is an important goal but 
think it is important to note that AHCPR has already addressed the two 
issues raised in this report.
  First, in the area of clinical practice guidelines, AHCPR has been 
responsive to the committee's concerns. The Agency took this criticism 
seriously, engaged in a dialog with the health care community, and 
announced last month that it will no longer directly support the 
development of clinical practice guidelines. Instead, AHCPR will 
concentrate on its strength, the development and assessment of the 
scientific evidence that physicians, health plans, and other providers 
need so that they, not AHCPR, can develop guidelines or other qualify 
improvement strategies. This approach will provide physicians and 
health plans with the information they need to develop better, 
evidence-based guidelines, without the implication that the Federal 
Government is telling them how to practice medicine.
  Second, the agency has been responsive in attempting to minimize 
their overlap with other Health and Human Services agencies in the area 
of the data collection. Despite the fact

[[Page E837]]

that AHCPR has only a small, but important, role in the area of data 
collection, the Agency took the lead in proposing a major restructuring 
of its medical expenditure survey to eliminate areas of duplication 
with other HHS surveys. The new medical expenditures panel survey that 
they are now undertaking reflects those survey integration efforts. I 
agree with the committee that it is important that the other agencies 
of the Department explore greater integration of their survey and data 
collection efforts; AHCPR has stepped up to the plate on this issue and 
their contribution should be acknowledged.
  In light of the responsiveness of AHCPR to our concerns, I think it 
is time to move forward. We have seen major reform and restructuring at 
this Agency and now we need to let it get on with its mission of 
identifying what works and what is cost-effective in health care. Its 
research has already demonstrated that better quality care can cost 
less if clinicians and patients have the information they need to make 
more informed choices. This research is crucial to our committee's 
efforts to reform and save the Medicare Program and we now need to let 
them do their job.

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