Goal 7: Support the overall direction and management of AHCPR (PS)
This goal involves supporting the overall direction and management of AHCPR through prudent acquisition performance
management, capital asset planning, personnel support and information technology planning.
Strategy
Objective 7.1 is included because it is mandatory, but it does not apply to AHCPR. The continued enhancement of the Agency
intranet (Objective 7.2) is a major step forward in communications for the Agency and will enable staff to work more efficiently and
effectively and with greater satisfaction.
Previous Successes
Progress achieved in developing the AHCPR Intranet:
- Provided an Agency Events Calendar and an Agency Planning Calendar.
- Provided an Agency Concepts data entry form and concepts search capability to assist in capturing and using information for
agenda planning/setting.
- Provided a Research Activities database for employees to quickly and easily search and identify all Agency Research Products.
- Provided a Uniform Research Reporting Guideline data entry and search capability for Project Officers to easily enter project
profiles and search Agency project information.
- Provided an Agency Controlled Correspondence and Action Item Tracking System.
- Provided a Virtual Information Resources Center (IRC) Library capability.
- Provided an Agency forms library with the capability to dynamically fill-in and print various Agency forms.
- Provided a Prototype of an Intranet accessible Grants Information and Tracking System for easy search and reporting of Grants
information.
- Provided an online Employee Directory with personal home page capability.
- Provided an Agency Power Point Presentation Library with dynamic update and search capability.
- Provided an Agency Management and Operations Policy Manual, replacing the need to distribute updates to the current manual.
- Provided a Conference Room Scheduling Capability.
- Provided a Prototype Distance Learning Web Site for the Uniform Liaison Program participants to gather information before a
workshop begins and to collaborate with instructors and participants after the workshop.
- Performed an Inventory and assessment of Agency Y2K compliance needs, with planned completion of Y2K remediation and
validation efforts by December 31, 1998.
Fiscal Year 1999 Objectives and Indicators
Fiscal Year 1999 Objective 7.1: Provide prudent planning for all capital assets.
AHCPR has no major fixed (capital) assets or information systems. However, AHCPR will continue to follow the principles and
guidance outlined in OMB Circular A-11 Part 3 with regard to planning, and developing fixed assets.
Fiscal Year 1999 Objective 7.2: Maintain acquisition performance management system to ensure: (1) timely completion of transactions, (2)
vendor and customer satisfaction, and (3) efficient and effective use of resources.
Indicators
1. Internal customer
satisfaction rated at minimum
of 4.5/5.
Baseline in fiscal year 1998: 4.2/5.
External customer satisfaction
rated at 4/5.
Baseline in fiscal year
1998: 3.6/5 .
2. Customer satisfaction
survey results assessed and
used to implement changes to
improve and enhance services.
Data Collection
Annual customer surveys of
AHCPR employees.
Fiscal Year 1999 Objective 7.3: Continued enhancement and expansion of Agency intranet site to ensure staff have immediate access to all current
information.
The site covers Agency administrative and operational processes, procedures, and policies. It also covers
information on ongoing health care research as well as results and findings from all the research supported by the Agency.
Indicators
1. Customer satisfaction rated
at minimum of 3.5/4.
Baseline
in fiscal year 1998 - 2.9/4.
2. Customer satisfaction
surveys assessed and used to
implement changes to improve
and enhance services as
necessary.
Baseline: Based on responses
to fiscal year 1998 survey, a totally
revised intranet will be
introduced in January 1999.
Data Collection
Annual customer surveys of
AHCPR employees.
Fiscal Year 2000 Objective 7.1: Provide prudent planning for all capital assets.
AHCPR has no major fixed (capital) assets or information systems. However, AHCPR will continue to follow the principles and
guidance outlined in OMB Circular A-11 Part 3 with regard to planning, and developing fixed assets.
Fiscal Year 2000 Objective 7.2: Maintain acquisition performance management system to ensure: (1) timely completion of transactions, (2)
vendor and customer satisfaction, and (3) efficient and effective use of resources.
Indicators
1. Internal customer
satisfaction rated at minimum
of 4.5/5.
Baseline in fiscal year 1998 - 4.2/5.
External customer satisfaction
rated at 4.5/5.
Baseline in fiscal year 1998 - 3.6/5.
2. Customer satisfaction
survey results assessed and
used to implement changes to
improve and enhance services.
Data Collection
Annual customer surveys of
AHCPR employees.
Fiscal Year 2000 Objective 7.3: Continued enhancement and expansion of Agency intranet site to ensure staff have immediate access to all current
information.
The site covers Agency administrative and operational processes, procedures, and policies. It also covers
information on ongoing health care research as well as results and findings from all the research supported by the Agency.
Indicators
Customer satisfaction rated at
minimum of 3.5/4.
Baseline in fiscal year 1998 - 2.9/4
Indicators Summary
Numerator—Customer satisfaction in fiscal year
2000.
Denominator—Customer satisfaction in fiscal year
1999.
Type and Significance
Outcome
Data Collection
Internal surveys of AHCPR
staff.
Indicators
Demonstration through
customer satisfaction surveys
that the daily work of staff has
been facilitated by the intranet.
Indicators Summary
Numerator—Number of respondents reporting
improvement in work
processes.
Denominator—Number of respondents.
Type and Significance
Outcome
Data Collection
Internal surveys of AHCPR
staff.
Indicators
Assessment of customer
satisfaction surveys and use of
such surveys to implement
changes to improve and
enhance services as
necessary.
Indicators Summary
Numerator—Number of changes made based
on satisfaction survey.
Denominator—Number of changes
requested/suggested in
satisfaction survey
Type and Significance
Outcome: A major goal of the intranet is
to help staff accomplish tasks
without having to re-create
work already finished, make
countless telephone calls, etc.
The customer satisfaction data
will identify whether these
problems have been mitigated.
Data Collection
Internal surveys of AHCPR
staff.
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Alignment: Fiscal Year 1999 Budget Lines, Funding Request, Annual Performance Plan Goals
Budget Line, Fiscal Year 1999, with Funding Request
Research on Health Care Costs and Quality (HCOQ), $140,914,000
Annual Performance Plan Goal:
1. Establish future research agenda based on users' needs.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
Annual Performance Plan Goal:
2. Make significant contributions to the effective functioning of the US health care system through the creation of new knowledge.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
- Secretary's Initiative to Improve Health Care Quality.
- Facilitate Consumers' Use of Information on Quality.
- Strengthen Value-based Purchasing by the Department.
- Outcomes for the Elderly and Chronically Ill.
- Clinical Preventive Services.
- Centers for Education and Research Therapeutics (CERTs).
- Improve the Quality of Children's Health.
Annual Performance Plan Goal:
3. Foster translation of new knowledge into practice by developing and providing information, products, and tools on outcomes, quality, and access, cost, and use of care.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
- Secretary's Initiative to Improve Health Care Quality.
- Measure National Health Care Quality.
- Expand Research that Improves Quality Outcomes for the Elderly and Chronically Ill.
- Improve the Quality of Children's Health.
Annual Performance Plan Goal:
4. Evaluate the effectiveness and impact of AHCPR research and associated activities.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
Evaluation projects proposed in Goal 4.
Annual Performance Plan Goal:
5. Support Department-wide Initiative to Improve Health Care Quality through leadership and research.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
Budget Line, Fiscal Year 1999, with Funding Request
Medical Expenditure Panel Survey (MEPS), $27,800,000
Annual Performance Plan Goal:
6. Collect current data and create data tapes and associated products on health care use and expenditures for use by public and private-sector decisionmakers and researchers.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
Medical Expenditure Panel Survey (MEPS) data collection and data products.
Budget Line, Fiscal Year 1999, with Funding Request
Program Support, $2,341,000
Annual Performance Plan Goal:
7. Support the overall direction and management of AHCPR.
Fiscal Year 1999 Priority Areas (1), Aligned by Annual Performance Plan Goal
Priority 2: Modify and enhance MEPS to enable reporting on the quality of health care in America
Budget Line, Fiscal Year 1999, with Funding Request
Total: $171,055,000
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Alignment: Fiscal Year 2000 Budget Lines, Funding Request, Annual Performance Plan Goals
Budget Line, Fiscal Year 2000, with Funding Request
Research on Health Care Costs and Quality (HCOQ), $167,914,000
Annual Performance Plan Goal:
1. Establish future research agenda based on users' needs.
Fiscal Year 2000 Priority Areas (1), Aligned by Annual Performance Plan Goal
Priority 3: Identify aims for improvement.
Annual Performance Plan Goal:
2. Make significant contributions to the effective functioning of the US health care system through the creation of new knowledge.
Fiscal Year 2000 Priority Areas (1), Aligned by Annual Performance Plan Goal
Priority 1: New research on priority health issues.
Priority 2: Tracking impacts of market consolidations.
Priority 2: Identify managed care practices that work.
Priority 3: Identify factors which lead to successful implementation and quality improvement.
Annual Performance Plan Goal:
3. Foster translation of new knowledge into practice by developing and providing information, products, and tools on outcomes, quality, and access, cost, and use of care.
Fiscal Year 2000 Priority Areas (1), Aligned by Annual Performance Plan Goal
Priority 2: Redesign and enrich HCUP.
Priority 3: Establish public/private partnerships and practice networks.
Priority 3: Fund experiments that test the effectiveness of improvement approaches.
Priority 3: Measure success of these strategies and promote broader implementation.
Annual Performance Plan Goal:
4. Evaluate the effectiveness and impact of AHCPR research and associated activities.
Annual Performance Plan Goal:
5. Support Department-wide Initiative to Improve Health Care Quality through leadership and research.
Fiscal Year 2000 Priority Areas (1), Aligned by Annual Performance Plan Goal
Budget Line, Fiscal Year 2000, with Funding Request
Medical Expenditure Panel Surveys (MEPS) $36,000,000
Annual Performance Plan Goal:
6. Collect current data and create data tapes and associated products on health care use and expenditures for use by public and private-sector decisionmakers and researchers.
Budget Line, Fiscal Year 2000, with Funding Request
Program Support $2,341,000
Annual Performance Plan Goal:
7. Support the overall direction and management of AHCPR.
Budget Line, Fiscal Year 2000, with Funding Request
Total $206,255,000
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(
1) Priority 1: New Research on Priority Health Issues, Priority 2: New Tools for a New Century, Priority 3: Accelerating the Pace of Quality Improvement.
Connection to HHS Strategic Plan
AHCPR is guided by and supports the strategic plan goals of the Department of Health and Human Services (HHS).
The Agency's activities contribute to five of the six HHS goals.
- HHS Goal 2: Improve the Economic and Social Well-Being of Individuals, Families, and Communities in the United States. (For example, through the Agency's research on children's health.)
- HHS Goal 3: Improve Access to Health Services and Assure the Integrity of the Nation's Health Entitlement and Safety
Net Programs. (For example, through the activities of the Agency's Center for Primary Care Research.)
- HHS Goal 4: Improve the Quality of Health Care and Human Services. (For example, through numerous Agency activities including quality measurement research and data development.)
- HHS Goal 5: Improve the Public Health System. (For example, through the Agency's data development and monitoring
activities and investments.)
- HHS Goal 6: Strengthen the Nation's Health Sciences Research Enterprise and Enhance Its Productivity. (For example,
through the Agency's research, data development, translation, and dissemination activities.)
A detailed summary of AHCPR's contributions to the HHS strategic plan follows, however, the Agency's contributions to
Goals 4 and 6 are of particular note.
AHCPR is the Department's lead Agency for health care quality activities and is a major contributor to Goal 4. Research
on the determinants of health care quality, effective and cost effective ways to improve health care quality, and how to
measure health care quality will be instrumental in achieving success in the goal's objectives. Additionally, the new
information developed, and then implemented in the health care system, from research on outcomes and effectiveness of
care, as well as access to, cost, and use of health care, will help close the gaps between what we know and what we need to know, on the one hand, and what we know and what we do in health care, on the other hand. AHCPR also supports HHS
Goal 4 through leadership of the Secretary's quality initiative, support of the Quality Interagency Task Force, contributions
to the HHS Race and Health Disparities Initiative, and close working relationships with other HHS Agencies and the Office
of the Secretary.
Within Goal 6, AHCPR's expanding portfolio in outcomes and effectiveness, quality, primary care, and other practice-based research, as well as extramural and intramural studies of issues pertaining to access, cost, organization, and delivery
of health care, will contribute to achieving objective 6.4. Additionally, AHCPR's substantial investment in the
development of databases will enable others to perform research and analyses to answer questions critical to understanding
the dynamics of the health care system.
AHCPR maintains its commitment to building the infrastructure needed to continue to conduct high-quality, cutting-edge
health care research for the next century through national training programs (the National Research Service Award
program), service fellows and summer intern programs, mentoring programs, and the provision of technical assistance to a
variety of its audiences. AHCPR will continue to support efforts to attract trainees from racial and ethnic minorities into
the field of health services research. These activities are aligned with Objective 6.6.
For the Nation's investment in research to reach its full potential, the results must be widely disseminated (Objective 6.7)
and implemented. The AHCPR Cycle of Research presented in section E.2. of this plan illustrates the important role that
dissemination will play in all areas of activity within the Agency. This focus aligns with Objective 6.7.
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Examples of AHCPR's Contributions to the HHS Strategic Plan
HHS Goal 2: Improve the Economic and Social Well-Being of Individuals, Families, and Communities in the United States
Objective 2.5: Increase Opportunities for Seniors to Have an Active and Healthy Aging Experience
Objective 2.6: Expand Access to Consumer-Directed, Home and Community-Based Long-term Care and Health
Services
AHCPR will conduct research in areas relevant to improving the aging experience in such areas as: (1) conditions of
particular importance to the Medicaid population; and (2) quality measurement issues and tool development for institutional
settings.
HHS Goal 3: Improve Access to Health Services and Assure the Integrity of the Nation's Health Entitlement and Safety
Net Programs
Objective 3.2: Increase the Availability of Primary Health Care Services
To test the effectiveness of health care improvement approaches, AHCPR will study such topics as: (1) the implementation
of evidence-based information in diverse health care settings to determine effective strategies for enhancing practitioner
behavior change and improving patient behavior, knowledge and satisfaction and (2) the factors which determine the
success of quality improvement strategies and to what extent these vary by the nature of the problem addressed and the
target population.
Projects to evaluate the impact of managed care will constitute a systematic effort to determine the impact of managed care
and other changes in the organization of care on health care quality; outcomes; and cost, use and access.
Objective 3.3: Improve Access to and the Effectiveness of Health Care Services for Persons with Specific Needs
AHCPR will examine how various clinical and system characteristics affect the health outcomes, quality access, and
satisfaction, for the elderly and chronically ill.
Objective 3.4: Protect and Improve Beneficiary Health and Satisfaction with Medicare and Medicaid
AHCPR activities supporting Medicare and Medicaid beneficiaries will include: (1) research on conditions that are common, costly, and for which there is substantial variation in practice, conditions that
represent major Medicare or Medicaid expenditures; (2) providing objective, science-based, timely information to health
care decision makers—patients and clinicians, health system leaders, and policymakers; (3) health care surveys, such as
CAHPS® and MEPS, that provide information supporting health plan choices and coverage decisions; and (4) studying the
national impact of the
Children's Health Insurance Program on access and cost of care for children.
HHS Goal 4: Improve the Quality of Health Care and Human Services
Objective 4.1: Promote the Appropriate Use of Effective Health Services
AHCPR is implementing a growing portfolio of evaluations that will show over time the outcomes of the investments of
Agency funds. The Agency will evaluate the use and usability of the Medical Expenditures Panel Survey (MEPS)
databases for their intended purposes. Other evaluations will assess: (1) evidence reports and technology assessments of
evidence-based practice centers; and (2) products that advance methods to measure and improve health-care quality,
including clinical quality improvement software (CONQUEST), the Consumer Assessment of Health Plans Survey (CAHPS®), and the
Expansion of Quality of Care Measures project (Q-SPAN).
Objective 4.2: Reduce Disparities in the Receipt of Quality Health Care Services
AHCPR will expand its commitment to conducting health services research that will help reduce disparities that exist for
racial and ethnic minorities. The Agency will also focus on building infrastructure for relevant research by training
minority and other investigators to address issues for minority populations.
Objective 4.3: Increase Consumers' Understanding of Their Health Care Options
CAHPS® is a tool for surveying members of health plans about their
experience with and assessment of the quality of health care they receive, and for reporting the results to other consumers
who are choosing a plan. AHCPR will continue its efforts to enhance CAHPS® and evaluate its use.
HHS Goal 5: Improve the Public Health System
Objective 5.1: Improve the Public Health Systems' Capacity to Monitor The Health Status and Identify Threats to
the Health of the Nation's Population
AHCPR will begin to increase the capacity of the Medical Expenditure Panel Survey (MEPS) to enable the development
of a national capacity to monitor the quality of care, particularly for populations of national interest, including the
chronically ill, poor, racial/ethnic minorities, and children.
AHCPR will redesign and expand Healthcare Cost and Utilization Project (HCUP) to provide state and community
decisionmakers a powerful set of linked databases they can use to monitor the impact of major system changes on access,
quality, outcomes and cost in their states and communities, and to compare these against the progress of other states and
communities.
AHCPR will build on past investments in tool development by focusing on expanding the toolbox. These tools will enable
purchasers, policymakers, health plans, providers, and patients to improve care.
HHS Goal 6: Strengthen the Nation's Health Sciences Research Enterprise and Enhance Its Productivity
Objective 6.2: Improve the Prevention, Diagnosis, and Treatment of Disease and Disability
To test the effectiveness of health care improvement approaches, AHCPR will: (1) study the implementation of
evidence-based information in diverse health care settings to determine effective strategies for enhancing practitioner
behavior change and improving patient behavior, knowledge, and satisfaction; and (2) identify the factors which determine
the success of quality improvement strategies and to what extent these vary by the nature of the problem addressed and the
target population.
Objective 6.4: Increase the Understanding of and Response to the Major Issues Related to the Quality, Financing,
Cost, and Cost-Effectiveness of Health Care Services
There are many gaps in knowledge in all areas of health care. New questions emerge as new technologies are developed,
the population's demographics change, areas of inquiry previously under-emphasized take on greater importance, and
research previously undertaken identifies further areas that need attention. Therefore, AHCPR will continue to focus on
creating new knowledge and assessing the findings that result from completed projects.
Objective 6.6: Improve the Quality of Medical and Health Science Research by Strengthening the Base of Highly
Qualified Scientific Investigators
AHCPR will invest in a number of programs to further the training of health services researchers to address the research
and analytic needs of the changing health care system. These priorities will build on prior efforts to make both curricula
and practical research experiences more relevant to decisionmakers' concerns about the effectiveness of health care and
issues of cost, quality, and access. Further, they will be designed to reflect and incorporate evolving innovations in data
systems and research tools so that the researchers of the future not only identify and address significant research questions,
but also employ cutting edge methodological, analytic, and data handling techniques, including appropriate privacy and
confidentiality safeguards.
Objective 6.7: Ensure That Research Results Are Effectively Communicated to the Public, Practitioners, and the
Scientific Community
Building on the previous 10 years of research findings, AHCPR will identify ongoing gaps between what we know now
and what we do in health care and will begin to close those gaps through research and demonstrations that develop and test
implementation strategies in different settings in the health care system. A major focus within this is identifying existing
implementation strategies in use in health care settings and demonstrating their applicability to wide spread dissemination
in other areas of the system.
AHCPR places considerable focus on developing tools and products that facilitate the transfer of research findings into
practice. The Agency has a well developed dissemination system that includes publications development, the Publications
Clearinghouse, and an award winning Web site. This emphasis is critical to the Agency's success. Ongoing plans include
incorporating regular customer feedback into our operations to continue to improve our efforts.
Submitted February 1, 1999, to the US Congress with the Justification of Estimates for Appropriations Committees for the Department of Health and Human Services, Fiscal Year 2000.
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Internet Citation:
Fiscal Year 2000 Performance Plan. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.gov/about/gpra2000/gpra00a.htm
540 Gaither Road Rockville, MD 20850