HHS releases 2014 budget

President Obama’s budget for the Department of Health & Human Services for fiscal year 2014 focuses on improving patient safety, building understanding and treatment of mental health problems, advancing scientific knowledge, examining new models for care and payment and contributing to a reduction of the nation’s debt.

HHS Secretary Kathleen Sebelius presented the department’s FY2014 budget during a press conference on April 9.

In light of the Sandy Hook school shooting in Newtown, Conn., last December, HHS is addressing mental health issues by investing $130 million to help affected students and young adults get treatment. The funding will support expansion of the behavioral health workforce and Project AWARE (Advancing Wellness and Resilience in Education), an effort to reach 750,000 young people through programs to train teachers and other adults who work with youth to detect and respond to mental illness.

It will incorporate lessons from the Youth Violence Prevention program and invest in state grants to help keep schools safe and get students with behavioral health issues referred to the services they need, and proposes a new Healthy Transitions program to support young people ages 16 to 25 and their families to access and navigate the behavioral health treatment systems. The budget also provides $30 million in new funding to the Centers for Disease Control and Prevention (CDC) to track gun violence and to research strategies to prevent it.

The budget includes $63 million for patient safety research at the Agency for Healthcare Research and Quality (AHRQ). In FY2014, AHRQ will fund projects to address the challenges of healthcare teamwork and coordination among providers and support research on how to establish cultures conducive to patient safety in healthcare organizations.

The FY2014 budget includes $31.3 billion for the National Institutes of Health (NIH), an increase of $471 million over the FY2012 level, reflecting the administration’s priority to invest in innovative biomedical and behavioral research that spurs economic growth while advancing medical science. Investment in NIH also helps drive the biotechnology sector and assure the nation’s place as a leader in science and technology, according to a data brief issued by CMS.

The budget will also substantially increase support for the National Registry of Evidence-based Programs and Practices. This searchable online system supports states, communities and tribes in identifying and implementing evidence-based mental health and substance abuse prevention and treatment interventions. Additional funding will be used to ensure the registry includes cutting-edge innovations that work.

The budget includes $40 million to begin significant investments in modernizing infectious disease tracking at the CDC.

It also earmarks $26 million, the same level as FY2012, for the AHRQ health IT research portfolio, including $20 million to support research grants that will generate foundational health IT research to improve the quality, safety, effectiveness and efficiency of U.S. healthcare. A total of $6 million will support contract activities related to synthesizing and disseminating evidence on meaningful use of health IT and developing the tools and resources for various stakeholders to implement best practices.

Another $100 million is slated for patient-centered health research provided through the Patient-Centered Outcomes Research Trust Fund (PCORTF). The PCORTF, established by the Patient Protection and Affordable Care Act, transfers funding to HHS to build research capacity, translate and disseminate comparative clinical effectiveness research, and establish grants to train researchers. In FY2014, investments will build on current AHRQ efforts, such as programs to train researchers in methods and standards for conducting patient-centered outcomes research and dissemination and translation efforts.

The budget includes $63 million for the AHRQ patient safety research portfolio, which supports activities which aim to prevent, mitigate and decrease the number of medical errors, patient safety risks and hazards, and quality gaps.

The Center for Medicare and Medicaid Innovation will focus, according to CMS, its resources on bundled payments, accountable care models and a comprehensive primary care initiative, among other endeavors.

The State Innovation Model provides up to $300 million to assist states in transforming their healthcare payment and delivery systems. In order to qualify for awards states must propose reforms that incorporate multiple payers and that are expected to improve quality of care, while reducing costs. Some states will receive funding to support the design of new payment and delivery models, while other (more advanced) states will receive funding to support the testing of such models. State awardees were announced in February.

Open enrollment for health insurance marketplaces begins October 1. The budget requests $803.5 million for CMS activities to support marketplace operations in FY2014. CMS also will collect user fees from issuers participating in the federally-facilitated marketplaces and state partnership marketplaces.