Agency That Supports Health-Care Improvement Cuts Off Grants

The Agency for Healthcare Research and Quality told multiple grant recipients this week they won’t receive continuing funding for previously awarded projects, cutting off dollars for ongoing efforts to improve America’s health-care system through research and training new scientists and clinicians.

Spokespeople for the Health and Human Services Department, which includes AHRQ, didn’t provide interviews or answer multiple written questions Friday from Inside Higher Ed, including how much funding the agency has denied. As of early Friday afternoon, AcademyHealth, which represents health services and health policy researchers, said it had gathered information on 67 cutoff grants, which lost nearly $97 million in “estimated remaining committed funding,” as the group put it. 

“Everything Americans hate about health care is what this research focuses on,” said Aaron Carroll, AcademyHealth’s president and chief executive officer. “You think health care costs too much in the United States? Really makes you angry? That’s AHRQ. You think it’s too hard to get in to see a doctor? Wait times are too long? That’s AHRQ.”

Timothy Beebe, a health-care management professor at the University of Minnesota, Twin Cities, said he’s been denied $3 million out of an expected $5 million five-year grant that helped train scientist-practitioners to more quickly introduce evidence-based practices into patient care and ditch costly, ineffective treatments. 

“I can’t see a way to continue it without this grant support,” Beebe said, adding that he’s afraid “we’re going to be losing a generation of scholars that really are in a position to change kind of the trajectory of the health-care-delivery system—where we’re spending more and more on health care without a lot of return on investment.” 

Early last month, Republican House appropriators proposed eliminating funding for AHRQ. The cancellations also underscore that the Trump administration continues to disrupt research funding, even before the White House Office of Management and Budget finalizes its proposed rule that would provide more legal justification for grant terminations. 

In an email to Inside Higher Ed, HHS disputed that these are grant terminations, suggesting they’re instead nonrenewals. But Carroll said, “I don’t understand the quibbling about the semantics.”

“When you’re midstream and you’re expecting the funding to come through and instead they don’t [provide funding] and tell you stop … you could pick a different word than ‘terminated,’ but it’s going to end,” Carroll said. He also said that researchers and the nation are losing more than just the denied continuing funds. 

“If you’ve started a huge study and you’ve already spent, let’s say, $2 [million] of $5 million on it and you’ve enrolled patients, that’s now wasted,” he said.  

In an email to Inside Higher Ed, HHS said, “AHRQ determined that certain non-competing continuation grants and jointly funded grants would not receive continuations awards.” The agency usually provides grant recipients continuing funding each year until the grant term is over, Carroll said. 

“Very rarely are they terminated,” Carroll said. “It does happen, but very, very rarely, and almost always for very specific reasons that everyone would know and understand. You would never be wondering why.” 

HHS told Inside Higher Ed that “under statute, the AHRQ Director must determine whether continuation funding is in the best interest of the federal government.” But it didn’t explain why the cutoff grants weren’t in the best interest of the federal government, or what that phrase means. (The undefined term “national interest” also appears in the proposed OMB rule.) HHS also didn’t provide a list of the canceled grants. 

The “best interest of the federal government” phrase appeared in four grant cutoff letters researchers received this week and provided to Inside Higher Ed.

None of the letters provide much detail about why AHRQ is ending the grants. One says, right after the reference to the “best interest of the federal government,” that “the program through which your grant was previously awarded, and the funding contract” that supported it, “have been canceled on this basis, resulting in the unavailability of funds.” 

The other three don’t have that, but they include an added paragraph.

“AHRQ’s current priorities include focusing agency resources on patient safety, preventing antibiotic resistance, telehealth, overmedication of children, use of digital health tools to improve health, long COVID, artificial intelligence, nutrition, furthering understanding of autism, promoting research focused on scientifically valid, measurable health outcomes and solution oriented approaches in health disparities research,” the letters say, adding that “as a result, AHRQ is adjusting its discretionary health services research award portfolio in order to better prioritize agency resources towards the above-mentioned priorities.”

But Carroll said that rationale doesn’t make sense, because many of the canceled grants, including one on antibiotic resistance, fit into that priority list.