Agency for Health Care Policy and Research Studies Own History to Avoid Repeating Past Mistakes

Assessment of the first decade of the Agency for Health Care and Policy Research

From 1999 to 2000, researchers at the New York Academy of Medicine conducted a study of the history of the federal Agency for Health Care Policy and Research.

In the study, investigators reviewed the agency's effectiveness in reaching its three original goals:

  • Funding to improve the scientific basis for medical practice.
  • Addressing the health care cost problem, particularly in Medicare.
  • Securing adequate funding for health services research.

Key Findings

Investigators found that Agency for Health Care Policy and Research was most successful at meeting this last goal. Its creation established a new, high-profile federal office with several funding streams.

The agency attempted to reduce variation in medical practice by carrying out large multidisciplinary, multi-institutional projects that focused on patient outcomes of specific clinical problems. But it later abandoned this approach because it was expensive, descriptive rather than prescriptive, and had little impact on clinical practice.

To address cost savings, the agency developed practice guidelines for conditions such as low back pain, some of which were attacked by medical professionals. The investigators also observed that the goal of significant cost savings was unrealistic and receded as concern grew about health care quality.