We urge you, in the strongest possible terms, to oppose any bill that terminates this agency and its important research.



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June 22, 2015 Dear Member of Congress: The 144 undersigned organizations representing patients, health professionals, hospitals, scientists, patients, employers, and insurers strongly oppose the fiscal year (FY) 2016 Labor, Health and Human Services, Education and Related Agencies appropriations bill as posted by the subcommittee on June 16. We are gravely concerned by the assault on science, particularly the elimination of the Agency for Healthcare Research and Quality (AHRQ). AHRQ s mission is to generate the evidence necessary to build a high-quality, high-value health care system. Put simply, AHRQ-funded research is being used in hospitals, private practices, health departments, and communities across the nation to make our health care system less complex and costly. Its research fuels innovation and improves quality, identifies waste, and enhances efficiency in the health care system. It is used by patients, their loved ones, and their health care professionals to make the right health care decisions for themselves and their families. This research helps Americans get their money s worth when it comes to health care. We need more of it, not less. To terminate AHRQ in the current fiscal environment is pennywise and pound foolish. Our nation spends $3 trillion annually on health care the largest share of which are federal purchases through Medicare, Medicaid, the Federal Employees Health Benefits Plan, insurance exchanges, TRICARE, and veterans health care. Americans deserve reliable information on how to deliver the best possible care, at the greatest value, with the best outcomes. AHRQfunded health services research provides those answers. We are deeply disappointed by the Labor, Health and Human Services, Education and Related Agencies appropriations bill and especially the attack on AHRQ. We urge you, in the strongest possible terms, to oppose any bill that terminates this agency and its important research. For more information on the Friends of AHRQ, contact Emily Holubowich at 202.484.1100 or eholubowich@dc-crd.com. Sincerely, Academic Pediatric Association Academy of Nutrition and Dietetics AcademyHealth Adult Congenital Heart Association Albert Einstein College of Medicine Alliance for Aging Research America's Essential Hospitals American Academy of Allergy, Asthma & Immunology American Academy of Ambulatory Care Nursing (AAACN)

American Academy of Family Physicians American Academy of Nursing American Academy of Pediatrics American Assembly for Men in Nursing (AAMN) American Association for Physician Leadership American Association for the Study of Liver Diseases American Association of Colleges of Nursing American Association of Colleges of Osteopathic Medicine (AACOM) American Association of Colleges of Pharmacy American Association of Nurse Anesthetists American Association of Nurse Assessment Coordination (AANAC) American Association of Nurse Practitioners American Association of Orthopaedic Surgeons American Association on Health and Disability American Board of Medical Specialties American College of Clinical Pharmacy (ACCP) American College of Nurse-Midwives (ACNM) American College of Occupational and Environmental Medicine American College of Preventive Medicine American College of Surgeons American Congress of Obstetricians and Gynecologists (ACOG) American Hospital Association American Medical Student Association American Nephrology Nurses' Association American Nurses Association (ANA) American Occupational Therapy Association (AOTA) American Organization of Nurse Executives American Osteopathic Association American Pediatric Society American Pediatric Surgical Nurses Association (APSNA) American Psychiatric Association American Psychological Association American Public Health Association American Society for Nutrition American Society for Reproductive Medicine American Society of Hematology American Society of Nephrology American Society of Pediatric Nephrology American Society of PeriAnesthesia Nurses (ASPAN) American Speech-Language-Hearing Association American Thoracic Society Arbor Research Collaborative for Health ARHP: the Association of Reproductive Health Professionals Association of Academic Health Centers Association of American Medical Colleges (AAMC) Association of Community Health Nursing Educators (ACHNE) Association of Departments of Family Medicine (ADFM) Association of Family Medicine Residency Directors (AFMRD) Association of Maternal & Child Health Programs Association of Medical School Pediatric Department Chairs

Association of Occupational Health Nurses (AAOHN) Association of Population Centers Association of Rehabilitation Nurses Association of University Radiologists (AUR) Association of Women's Health, Obstetric and Neonatal Nurses Asthma and Allergy Foundation of America (AAFA) Billings Clinic BJC HealthCare Boston University School of Public Health California Consortium of Addiction Programs and Professionals Cedars-Sinai Health System Cincinnati Children's Hospital Medical Center Coalition for Health Funding Coalition of National Health Education Organizations (CNHEO) Commissioned Officers Association of the U.S. Public Health Service, Inc. (COA) Connecticut Certification Board Consortium of Social Science Associations Cornell University Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine Duke University School of Medicine ECRI Institute Group Health Cooperative Guidelines International Network/North America (G-I-N/NA) Healthcare Information Management and Systems Society (HIMSS) Healthy Teen Network Heart Rhythm Society HIV Medicine Association HIV Services, Alameda Health Systems Illinois Alcohol and Drug Dependence Association Indiana University Institute for Health, Health Care Policy, and Aging Research International Certification and Reciprocity Consortium International Society of Psychiatric Mental Health Nurses (ISPN) Kaiser Permanente Lakeshore Foundation March of Dimes Marshfield Clinic Health System Medica Research Institute Montefiore Medical Center Morehouse School of Medicine Muskie School of Public Service, University of Southern Maine NAPHSIS National Alliance of State & Territorial AIDS Directors National Association of County and City Health Officials National Black Nurses Association National Center for Health Research National Gerontological Nurses Association National Hemophilia Foundation National Hispanic Medical Association National Kidney Foundation

National League for Nursing National Nursing Centers Consortium National Organization for Nurse Practitioners in Women's Health (NPWH) North American Primary Care Research Group (NAPCRG) Nurses Organization of Veterans Affairs (NOVA) Oncology Nursing Society Oregon Health & Science University Palo Alto Medical Foundation Research Institute (PAMFRI) Pediatric Policy Council Penn Medicine Penn State College of Medicine Physician Assistant Education Association Population Association of America Public Health Institute RTI International Ryan White Medical Providers Coalition Society for Healthcare Epidemiology of America Society for Maternal-Fetal Medicine Society for Medical Decision Making (SMDM) Society for Pediatric Research Society for Public Health Education Society for Women's Health Research Society of General Internal Medicine Society of Teachers of Family Medicine (STFM) The Center for Healthcare Organizational and Innovation Research (CHOIR), School of Public Health, UC-Berkeley Trust for America's Health Tulane University University for the Division of Health Policy and Management, School of Public Health, University of Minnesota University of Miami Miller School of Medicine University of South Florida Health University of Washington University of Wisconsin-Madison UNTHSC School of Public Health Wateree AIDS Task Force, Sumter, SC 29150 WomenHeart: The National Coalition for Women with Heart Disease

July 13, 2015 Dear Senator: The 185 undersigned organizations representing patients, health professionals, hospitals, scientists, medical schools, employers, and insurers are very concerned by the 35 percent reduction in funding for the Agency for Healthcare Research and Quality (AHRQ) in the Senate s fiscal year (FY) 2016 Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) appropriations bill. AHRQ s mission is to generate the evidence necessary to build a high-quality, high-value health care system. Put simply, AHRQ-funded research is being used in hospitals, private practices, health departments, and communities across the nation to make our health care system less complex and costly. Its research fuels innovation and improves quality, identifies waste, and enhances efficiency in the health care system. It is used by patients, their loved ones, and their health care professionals to make the right health care decisions for themselves and their families. This research helps Americans get their money s worth when it comes to health care. We need more of it, not less. Lawmakers face difficult choices in funding myriad priorities with increasingly limited resources, but deep to cuts to AHRQ in the current fiscal environment is pennywise and pound foolish. Our nation spends $3 trillion annually on health care the largest share of which are federal purchases through Medicare, Medicaid, the Federal Employees Health Benefits Plan, insurance exchanges, TRICARE, and veterans health care. Americans deserve reliable information on how to deliver the best possible care, at the greatest value, with the best outcomes. AHRQfunded health services research provides those answers. Without AHRQ and health services research to determine what treatments work best, for whom, and in what settings, the cures and treatments developed by the National Institutes of Health (NIH) will fall short on their promise to patients. We recognize the reduction in AHRQ s budget authority is largely a function of the historically low and grossly inadequate subcommittee allocation for health research and other critical public health, education, and workforce training programs in this bill. We hope lawmakers will work together to enact sequestration relief, increase the Labor-HHS subcommittee allocation, and restore AHRQ s budget authority to $364 million in the final FY 2016 appropriations legislation. For more information on the Friends of AHRQ, contact Emily Holubowich at 202.484.1100 or eholubowich@dc-crd.com. Sincerely, AACC Academic Pediatric Association Academy of Nutrition and Dietetics AcademyHealth Adult Congenital Heart Association

Albert Einstein College of Medicine Alliance for Aging Research AMDA The Society for Post-Acute and Long-Term Care Medicine American Academy of Allergy, Asthma and Immunology American Academy of Family Physicians American Academy of Nursing American Academy of Otolargyngology - Head and Neck Surgery American Academy of Otolaryngic Allergy American Academy of Pediatrics American Assembly for Men in Nursing (AAMN) American Association for Dental Research American Association for Physician Leadership American Association of Colleges of Nursing American Association of Colleges of Osteopathic Medicine (AACOM) American Association of Colleges of Pharmacy American Association of Neuromuscular and Electrodiagnostic Medicine American Association of Nurse Anesthetists American Association of Nurse Assessment Coordination (AANAC) American Association of Nurse Practitioners American Association of Occupational Health Nurses (AAOHN) American Association of Orthopaedic Surgeons American Association on Health and Disability American Board of Medical Specialties American Cancer Society Cancer Action Network American Chiropractic Association American College of Cardiology (ACC) American College of Clinical Pharmacy (ACCP) American College of Nurse-Midwives American College of Occupational and Environmental Medicine American College of Physicians American College of Preventive Medicine American College of Rheumatology American College of Surgeons American Congress of Obstetricians and Gynecologists American Gastroenterological Association American Heart Association American Medical Student Association (ASMA) American Nephrology Nurses' Association American Nurses Association American Occupational Therapy Association American Optometric Association American Osteopathic Association American Pediatric Society American Pediatric Surgical Nurses Association (APSNA) American Psychiatric Association American Psychological Association American Public Health Association American Society for Nutrition American Society of Hematology American Society of Nephrology

American Society of Pediatric Nephrology American Society of PeriAnesthesia Nurses (ASPAN) American Society of Plastic Surgeons (ASPS) American Speech-Language-Hearing Association (ASHA) American Thoracic Society Arbor Research Collaborative for Health ARHP: the Association of Reproductive Health Professionals Association for Clinical and Translational Science (ACTS) Association of American Medical Colleges (AAMC) Association of Community Health Nursing Educators Association of Departments of Family Medicine (ADFM) Association of Family Medicine Residency Directors (AFMRD) Association of Maternal & Child Health Programs Association of Medical School Pediatric Department Chairs Association of Population Centers Association of Rehabilitation Nurses Association of Schools and Programs of Public Health Association of University Radiologists Association of Women's Health, Obstetric and Neonatal Nurses Asthma and Allergy Foundation of America Baylor Scott & White Health Billings Clinic BJC HealthCare Boston Children's Hospital Boston University School of Public Health Brown University Center for Long-Term Care Quality & Innovation California Consortium of Addiction Programs and Professionals Cedars-Sinai Medical Center Cincinnati Children's Hospital Clinical Research Forum Coalition for Clinical and Translational Science Coalition for Health Funding Coalition of National Health Education Organizations College of Healthcare Information Management Executives (CHIME) Columbia University Medical Center Commissioned Officers Association of the U.S. Public Health Service, Inc. (COA) Connecticut Certification Board Consortium of Social Science Associations Cornell University Creighton University School of Medicine Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine Duke University School of Medicine ECRI Institute Federation of Associations in Behavioral and Brain Sciences Fight Colorectal Cancer GBS CIDP Foundation International Global Healthy Living Foundation Group Health Cooperative Guidelines International Network/North America (G-I-N/NA) Health Quality Advisors, LLC

Healthcare Information and Management Systems Society (HIMSS) Healthy Teen Network HIV Medicine Association Illinois Alcohol and Drug Dependence Association Indiana University International Certification and Reciprocity Consortium International Society of Psychiatric-Mental Health Nurses Lakeshore Foundation March of Dimes Marshfield Clinic Health System Mayo Clinic Medica Research Institute Montefiore Medical Center Morehouse School of Medicine Muskie School of Public Service, University of Southern Maine NAPHSIS National Alliance of State & Territorial AIDS Directors (NASTAD) National Alopecia Areata Foundation National Black Nurses Association National Center for Health Research National Committee for Quality Assurance (NCQA) National Gerontological Nurses Association National Hemophilia Foundation (NHF) National Kidney Foundation National League for Nursing National Nursing Centers Consortium National Organization for Nurse Practitioners in Women's Health (NPWH) National Partnership for Women & Families NextGen Healthcare North American Primary Care Research Group (NAPCRG) Nurses Organization of Veterans Affairs (NOVA) NYU Langone Medical Center Ochsner Health System Oncology Nursing Society Oregon Health & Science University Palo Alto Medical Foundation Research Institute (PAMFRI) Partners HealthCare Pediatric Policy Council Penn Medicine Penn State University Physician Assistant Education Association Population Association of America Public Health Institute Pulmonary Hypertension Association Saint Francis Care Scleroderma Foundation Society for Academic Emergency Medicine Society for Healthcare Epidemiology of America (SHEA) Society for Maternal-Fetal Medicine Society for Medical Decision Making (SMDM)

Society for Pediatric Research Society for Public Health Education Society for Women's Health Research Society of General Internal Medicine (SGIM) Society of Teachers of Family Medicine (STFM) The American Hospital Association The Center for Healthcare Organizational and Innovation Research (CHOIR), School of Public Health, UC-Berkeley The Leapfrog Group The Marfan Foundation The Ohio State University Wexner Medical Center The Sturge-Weber Foundation Trust for America's Health Tulane University UC Irvine Health UC San Diego Health University for the Division of Health Policy and Management, School of Public Health, University of Minnesota University of California University of California, Davis University of Nebraska Medical Center (UNMC) University of New Mexico Health Sciences Center University of North Carolina Health Care System University of North Carolina School of Medicine University of Pittsburgh Medical Center (UPMC) University of Pittsburgh Medical Center (UPMC) Community Providers Services University of South Dakota Sanford School of Medicine University of South Florida Health University of Washington UNTHSC School of Public Health Wake Forest Baptist Medical Center Wateree AIDS Task Force, Sumter, SC 29150