Announced in June 2025, CMS has introduced – ironically within days of celebrating major private health insurers’ pledge to pare back prior authorization – the WISeR program, which brings new prior authorization requirements to traditional Medicare, where prior authorization has historically been used very sparingly. Framed as a way to curb “fraud, waste, and abuse,” the WISeR model applies new prior authorization requirements for certain health services for which it has not historically been required, and it deploys artificial intelligence (AI) and machine learning (ML) to assess the clinical appropriateness of the prescribing and the consistency with Medicare coverage rules.

The argument here is simple: Traditional Medicare’s fee-for-service model produces an incentive structure that can fuel the ordering of unnecessary tests and treatments, and prior authorization can impose important guardrails on this practice.

It is not a secret that there is overuse in the American health care system, certainly including but extending beyond the realm of traditional Medicare. It is also not a secret that low-value care can accrue to large sums of money – over $100 billion annually, by some estimates – faced by the American health care system and, depending on the patient’s health plan, the patients themselves. The real question centers on whether this health policy problem is best addressed with a hammer or with a scalpel. That is, is introducing new prior authorization – with administration facilitated by AI programs – the appropriate solution?

The adoption of WISeR suggests that answer to that question is “no.”

WISeR’s Early Report Card

WISeR’s hasty rollout had already raised concerns that the rapid introduction of these new requirements would fuel confusion, errors, longer wait times, and stress. And in April 2026, the Office of Senator Maria Cantwell (WA) released a report on the State of Washington’s experience as one of the six pilot states, and the findings are troubling in and of themselves, and especially so through the lens of my book Coverage Denied: How Health Insurers Drive Inequality in the United States, which shows how insurance barriers drive administrative burden, or the experience of policy implementation as onerous.

Analysis revealed that not only are seniors in Washington waiting two to four times longer than prior to the introduction of the WISeR model to obtain covered procedures, but that the WISeR model relies on a third-party company that not only deploys AI tools, but reaps additional financial rewards for each denied claim, under the assumption that these claims constitute wasteful spending by Medicare.

Reflecting on this reduced access to care, the President of Yakima Memorial Hospital, Tammy Buyok said, “We are seeing instances where automated decision making may interfere with timely access to medically appropriate services that Medicare patients have long relied on.”

In fact, despite the seeming advantages that AI might boast when it comes to speed of processing, the report found that wait times for approval frequently exceeded CMS standards, taking as long as 15-20 days for approval of routine care rather than the advertised three days.

Critically, Washington is not alone in experiencing these adverse effects of WISeR’s rollout, with KFF Health News documenting “horrendous” experiences across the other five pilot states, with some patients even planning to pursue care out-of-state to avoid being ensnared in this red tape more commonly associated with private insurance. And physicians in all six of the pilot states told The Washington Post that their patients were navigating more cumbersome processes than previously, thanks to WISeR’s introduction of AI-driven prior authorization.

Why Prior Authorization Is Especially Burdensome for Seniors

Prior authorization ranks as Americans’ greatest burden in obtaining prescribed medical care, but these challenges may be especially pronounced for seniors, WISeR’s target population. Not only are seniors more likely to experience health problems that may raise the stakes of a denial, but their typically greater health needs combine with typically more limited disposable income, such that paying out-of-pocket may prove particularly infeasible. And while physicians’ offices may be able to assist with appeals, prior authorization constitutes a notable source of physician burden and those residing in rural communities may find that their medical practices are stretched especially thin, unable to afford to support the more extensive staffing found in academic medicine and leaving patients to navigate much of this new red tape.

While most prior authorizations are approved, this varies widely across medical services, as a June 2026 Health and Human Services Office of the Inspector General report on prior authorization denials illustrated, and prior authorization constitutes an important vehicle for delays and denials of coverage. Though appeal processes are in place, my book and related work help to illuminate the profound burdens of pursuing this recourse – burdens that seniors may be especially ill-equipped to navigate.

After all, effectively navigating the complexities of modern medicine – including materials that are written at as high as the 13^th grade reading level – requires a high level of health and health insurance literacy, which few Americans possess and which seniors are especially unlikely to possess.

Navigating a multi-stage health insurance appeal process that is described in a complex manner can be challenging on a good day. It may feel downright impossible in the setting of a health concern and broader cognitive decline because the red tape is so immense, constituting health care rationing by inconvenience, or health care barriers that come not from a final denial, but rather from the accumulated hurdles to access benefits. And while this overwhelm is widespread, it is also inequitable in its distribution: I find that patients from marginalized backgrounds are especially unlikely to appeal denials and are especially unlikely to be successful if they appeal.

And in addition to the navigation anxiety, patients facing delays and denials experience a psychological toll, with one patient interviewee from my book reflecting, “Is there something wrong with me? Do I not deserve this? Do I think my need is more important than it really is? The process makes you feel so small.”

Cumulatively, this evidence suggests that health insurance barriers can exacerbate administrative burdens felt by patients (as well as their providers, who are tasked with submitting additional documentation to support their prescribing decisions) and act as a structural driver of inequity among patients (some of whom may have limited health insurance literacy) and among rural and urban medical practices (the former of which pay particularly struggle amid new, complex prior authorization demands and chronic understaffing).

Looking Ahead

Whether WISeR ultimately reduces unnecessary care – ostensibly the program’s objective – remains an open empirical question. It is likewise unclear to what extent the program might be modified to respond to emerging concerns.

But the evidence from the program’s first seven months suggests that it is already exacerbating administrative burden and delaying medically necessary care for enrollees. Guarding against costly overuse is certainly a legitimate goal, but health policies cannot be judged simply by their intentions, but also by the access, quality, and value that they produce. By that standard, WISeR’s early report card raises serious concerns.

It is known that it takes 17 years for only 14 percent of research evidence to reach patients. This lag between biomedical discoveries and their implementation to influence care, coupled with the fast-changing clinical context, has led healthcare leaders to see the speed and focus of research as “out of sync” with their needs and that rapid, iterative learning is needed. Through the MN-LHS, with its focus on embeddedness and engaged co-creation, we have been working to bring that down to something closer to 17 months or 17 weeks. Traditional clinical and health services research training programs aren’t equipped to produce these types of scientists or these kinds of results - ours is.

With the support of the now-terminated grant, we built a new learning health system infrastructure designed to move research evidence into practice more quickly, broadly, and equitably. The goal was to help health systems use new evidence to improve care and health outcomes. The infrastructure is composed of technical processes, such as access to curated and mutualized medical records and administrative claims data on shared platforms, as well as a social infrastructure where patients, clinicians, health system leaders, and researchers can connect, co-create, share ideas, and establish priorities. This collaboration is supported through regular mentoring meetings, biweekly Design Shop sessions, monthly LHS iMpact seminars, and an annual Advances in Learning Health System Sciences conference. The conference attracts more than 350 attendees from all 12 major Minnesota health systems, including researchers, clinicians, administrators, health system leaders, patients, community partners, and C-suite executives.

Our program has been continuously funded by AHRQ since 2018. We have trained over 40 scientists from five different health systems within Minnesota who serve children and adolescents, women, the elderly, underrepresented urban/inner city and rural populations, Veterans, tribal members, and individuals with multi-morbidity (aligning almost completely with AHRQ’s Priority Populations). Our program is highly multi-disciplinary, composed of clinicians, clinician investigators, and non-clinical doctoral-level scholars from backgrounds such as primary care, various medical subspecialties, nursing, pharmacy, anthropology, sociology, engineering, epidemiology, and beyond. [More information on the backgrounds and work of the MN-LHS scholars and fellows can be found here.] Many of their innovations have been adopted into routine care, with great and sustained impact, because they are embedded within practices and responsive to stated system priorities.

Examples of their work include:

• Developed and implemented an anticoagulation clinical practice guideline for COVID-19 patients via a clinical decision support system that led to a 61% lower risk of progressing to severe disease (need ICU) and lowered risk of severe COVID-19, mortality, and reduced bleeding complications.

• Developed and implemented a new physiologically grounded definition of acute clinical deterioration that identified events a median of 157 minutes earlier than unplanned ICU transfer and was strongly and significantly associated with 7-day mortality.

• Conducted a large-scale placebo-controlled clinical trial of metformin, ivermectin, and fluvoxamine for early outpatient treatment of SARS-CoV-2 infection (the COVID-OUT study). Citing the results of this trial, BFARM (the FDA equivalent in Germany) recently passed a federal requirement that insurance cover metformin for the new indication of preventing Long COVID.

• Conducted a study that identified the specific needs of patients, care partners, and clinicians around functional recovery following hospitalization for people living with dementia, which informed how post-hospitalization rehabilitation programs can be designed to better serve this population.

• Investigated the identification and management of dementia in primary care within a safety-net healthcare system. Results showed that dementia and cognitive impairment (CI) are being identified, but diagnoses are non-specific.

• Conducted a study of the relationship between past sexual trauma and cervical cancer screening experiences and completion among female Veterans, as well as patient and staff perspectives on self-collected HPV testing. The scholar found that those with past sexual trauma were twice as likely as those without to report moderate to high levels of physical and psychological distress associated with pelvic examinations, and twice as likely to have ever put off or delayed an exam due to distress. Interviews showed that patients and staff agreed that self-collected HPV testing could provide a trauma-sensitive option for Veterans. These local experiences are serving as a model nationally, both within the and outside of the VA.

• Developed and implemented a new “whole-of-office” approach to providing lung screening recommendations to patients in rural parts of Minnesota that helped overcome the barriers some rural residents face when it comes to scheduling those screenings. The scholar observed a 30% increase in the number of screening orders for eligible patients in a pilot study conducted in a single clinic. There are plans to scale the model statewide.

As outlined in their original funding announcement, AHRQ’s LHS E-StaR program and its 16 funded P30 centers were designed to prepare clinicians and researchers for independent careers as embedded learning health system scientists; strengthen learning health system infrastructure through partnerships among health systems, academic institutions, and community stakeholders; support patient-centered and comparative effectiveness research; and create pathways to future federal research funding. The program also emphasized direct engagement with health system and community leaders through shared sponsorship and support, while advancing health equity, workforce diversity, and the integration of research and care delivery.

Without the support of the P30 grant, none of the above goals will be fully realized. With the termination of the E-StaR program and its constituent centers (including ours), we will be unable to build upon all that has been accomplished over the past several years and will lose future generations of engaged and embedded translational researchers. It is now likely that the aforementioned translation gap between discovery to practice will continue to widen and low value care may become the norm. The U.S. spends over $5.3 trillion on healthcare annually (about 20% of its GDP). Yet, one third of what we spend annually is unnecessary, ineffective, preventable, or harmful. Patients receive only 55 percent of recommended care. The LHS scientists supported by AHRQ’s E-StaR program generally and MN-LHS in particular were making positive progress in addressing these challenges. That will now end if the current funding situation holds. It is clear that AHRQ’s removal of support for this work could not have come at a more inopportune time.

AHRQ-funded research has been key to improving patient safety for more than thirty years. According to coverage in CBS News, “the agency is perhaps best known for its work on curbing hospital infections. Practices introduced because of AHRQ-funded studies prevented an estimated 20,500 deaths and saved $7.7 billion in healthcare costs from 2014 to 2017 alone.”

It cannot be overemphasized that AHRQ is the only agency dedicated to health services research whose function is to study care delivery, patient safety, and improve patient experiences in health systems. A 2023 study from the New England Journal of Medicine found that adverse events occurred in nearly one in four hospital admissions, and approximately one fourth of the events were preventable, which further underscores the need for continuous investment in patient safety and risk reduction.

Improving Patient Safety at Hospitals and Health Systems for At-Risk Groups:

Several AHRQ-funded grants represent efforts to address patient safety at critical points in care, with researchers developing potential solutions that could have improved outcomes for patients most vulnerable to harm.

For example, Dr. Dana Sax, a practicing emergency medicine physician, was developing an EHR-integrated clinical decision support tool that uses machine learning to help emergency department nurses make more accurate triage decisions and ultimately improve care for patients with acute medical conditions. The new triage system would help triage teams prioritize the sickest patients to reduce critical delays in care associated with ‘mis-triage,’ or delays in care because patients have been assigned an incorrect urgency level compared to the true severity of the patient’s illness. For example, for those who are experiencing septic shock, heart attack, or stroke, early identification and timely care delivery are critical. A triage system at the emergency department aimed to benefit vulnerable patients, reduce emergency department crowding, and help nurses get a full picture of the patient they are triaging, including comorbidities, medications, housing status, or previous hospitalizations, which can all inform whether a patient is in higher need of care. However, due to the canceled grant, they have not been able to develop the tool as planned, fully implement it, or evaluate its potential effectiveness.

Another researcher, Suchitra Rao, M.D., shared the story of a child with multiple medical complexities who died from the flu after missing his routine vaccination. Her AHRQ-funded study was designed to prevent such tragedies from occurring. She created a randomized controlled trial across 11 health systems to test whether hospitals could reliably identify high-risk children and vaccinate them against the flu before sending them home, rather than counting on busy outpatient care. This study was in its third year out of five when it was abruptly halted. Without the completed research, we lose valuable evidence about how to make vaccination more accessible for vulnerable children and their families.

Medical errors and patient safety events also disproportionately impact marginalized groups and are a driver of health disparities—with Black women more likely to experience both underdiagnosis and patient safety risks. Denise Quigley, Ph.D., from the RAND Corporation sought to compare the safety culture, hospital resources, and patient safety outcomes between Black-serving and non-Black-serving hospitals across the United States. This project is significant because it didn’t just document disparities but examined the environment in which care was delivered so hospitals could make tangible improvements to staffing, workloads, communication, and more to reduce these disparities across hospitals.

Improving Care Delivery Outside Health Systems

Patient safety doesn’t just happen in hospitals. Emergency medical services (CMS) professionals face high-stakes situations in unpredictable environments. The canceled Resilient EMS Patient Safety Learning Laboratory (PSLL) grant was designed to study how EMS professionals make decisions in real time and translate what researchers learned into practical, human-centered interventions. Its cancellation interrupts efforts to understand how to make emergency care safer before patients ever set foot in the hospital. Notably, the project focused on older adults experiencing potentially life-threating medical events and engaged experts in systems engineering, communication, geriatrics, as well as patient and family caregiver partners.

On the other end of the patient journey, Lipika Samal, M.D., was working to improve outcomes for elderly patients with multiple chronic conditions who have been discharged from the hospital. Older adults and vulnerable patients are especially at risk after discharge and during care, which could lead to adverse events, falls, medication errors, and readmissions. Samal and her team had been developing a care transitions app to bridge the gap between the hospital, home, and primary care during the first 30 days after hospitalization. The goal of the app is to include care plans and allow users to participate in modules to better understand their health and manage chronic conditions. However, due to the cancellation, researchers are unsure if they have enough usable data to draw any conclusions and were 60 percent of the way to their recruitment goal for a clinic trial – wasting time and resources – without being able to definitively know if the app would have reduced hospital readmissions. Hospital readmissions have an average cost of $16,037 per 30-day readmission further highlighting that AHRQ played a key role in reducing health care costs while making patients safer.

For children with complex needs, much of their health care happens at home, where the safety risks look different than in a traditional medical setting. SafeCare@Home4Kids Patient Safety Learning Lab, led by Carolyn C. Foster, M.D., worked to design safer home health care for children and engage families and caregivers who often take on the responsibility of trained medical professionals while going about their everyday lives. The project sought to prevent safety problems in the home involving medications and medical devices while giving families the tools to recognize problems and respond when they occur. Its cancellation doesn’t just disrupt the research but has real-world implications for the families and children that would have benefited from these interventions.

Disrupting Diagnostic Delays

Diagnostic delays and errors carry significant risk both to patients that could result in long-term health challenges or even death while costing health systems billions in wasted testing, repeat procedures, hospital stays, and even malpractice lawsuits. Two AHRQ-funded grants mitigate diagnostic delays by centering patients. The Patient-Partnered Diagnostic Center of Excellence, run by Kristen Elizabeth Miller, DrPH from MedStar Health, studied diagnostic breakdowns through patients’ experiences and developed methods to make those experiences actionable. The project aimed to integrate families and patients as members of the diagnostic team rather than just recipients of care. Safety-II Together, led by Eric Thomas, M.D. studied how patients and clinicians can work together as a team to maintain safety across an ongoing, fragmented diagnostic process. This mattered especially for patients with multiple chronic conditions and patients who aren’t proficient in English. Both projects sought to bring the patient perspective to prevent diagnostic errors. Their cancellation also ends the evidence pipeline of promising research that could have saved money, time, and lives.

Real Costs, Real Lives

What’s perhaps most significant about these canceled grants is that they span various ways patients may receive care from the patient’s home, ambulance, hospital stay, and potential diagnosis. The canceled grants were generating evidence that allowed health systems to identify safety risks, learn what works, improve care, and learn from their mistakes. Patients depend on these systems during their most vulnerable moments and now we may ever see the results of studies designed to prevent adverse safety events, reduce diagnostic delays, prevent readmissions, and most—all of which have costs to patients and health systems on top of the time, money, and effort that has already been invested in this research. As we’ve said before and will say again, for these canceled AHRQ-funded projects, time, money, and effort has been invested in research and we will never know the end results. As former AHRQ leaders themselves have said, patient safety is a real concern and patients should never be injured while receiving care meant to heal them and should never been seen as a partisan issue but instead is the very mission AHRQ has promised to uphold.

This post was written by AcademyHealth Digital Communications Manager Christina Tudor

These pieces of “sludge”—redundant steps, unclear instructions, and fragmented systems—expect patients to become part-time administrators. Fragmentation means one provider, another biller, and a third processor each have different rules; when something goes wrong, you’re bounced between phone lines and left with hold music and more confusion. The consequence isn’t just inconvenience: people with less time, fewer resources, or less familiarity with bureaucracy are far less likely to secure reimbursements, deepening financial strain and eroding trust in the system.

Administration is necessary, but it should not be punitive. Clear communication, standardized forms, reduced redundancy, better coordination, and user-centered design can dramatically lower patient burden. Small changes increase the likelihood that people will follow through on claims and get the relief they need.

AcademyHealth and Healthcare Triage have teamed up to spotlight these powerful but often invisible. Watch the series to see how seemingly small design choices shape health outcomes—and join the push to design systems that work for people, not against them.

You can find all videos in this series here.

But even as a medical student, I found myself asking questions: What systems surround my patients? Why do patients with seemingly identical conditions experience such different outcomes? Why do errors happen in hospitals? How do we learn from the causes of these problems to make our health care system better?

I was learning to care for one patient at a time. But I also began to wonder who was responsible for making the health care system itself better.

For decades, the answer has been a small federal agency that few Americans have heard of - the Agency for Healthcare Research and Quality (AHRQ). AHRQ studies how health care is delivered. It asks questions such as: Will treatments actually improve outcomes? How do we make hospitals safer? Which models of care produce better results at lower cost?

AHRQ investments have made meaningful impacts on saving lives and money. For example, the AHRQ-funded Comprehensive Unit-based Safety Program, focused on reducing central line infections in adult ICUs, reduced infections by 41 percent, with hundreds of lives saved and $100 million in excess costs to the health system avoided.

AHRQ also helped to establish the idea of a learning health system. Learning health systems use, for example, a hospital’s internal data, patient experiences, and scientific evidence to drive real-time quality improvement, safety, and best practices directly at the point of care. For example, in the NICU, researchers have used data already collected at the bedside to develop the neonatal Sequential Organ Failure Assessment, or nSOFA, which helps identify infants at greatest risk of dying from an infection. This is a case of the system learning from information generated caring for a critically ill infant to improve care for the next.

My own career showed me what that kind of learning can make possible.

In the early 2010s, as prescription opioid use accelerated across the country, I began seeing something unusual: babies in the NICU experiencing opioid withdrawal. Using AHRQ’s HCUP Kids’ Inpatient Database, my colleagues and I found that diagnoses of neonatal opioid withdrawal had tripled between 2000 and 2009, accounting for nearly three-quarters of a billion dollars in hospital charges. That study launched my career and ultimately led to years of research on improving care for pregnant women, infants, and families affected by opioid use disorder.

Two weeks ago, my colleagues and I received notices that our AHRQ grants, despite being in the middle of their funding periods, would no longer be supported. The decision was unprecedented. One of my grants trained the next generation of health services researchers. Young investigators moved across the country for this opportunity, only to find the support had disappeared. More than 100 grants totaling over $100 million have now been canceled. These were not minor reductions. They effectively dismantled the agency’s research enterprise.

The loss is bigger than grants themselves. I think about the next premature infant who develops an infection because we failed to learn from another hospital’s success. I think about the pregnant woman who cannot find treatment because we never studied which models of care work best. I think about taxpayers who spend trillions of dollars each year on health care without knowing whether we are investing those dollars wisely.

Congress reaffirmed AHRQ’s mission in the Healthcare Research and Quality Act of 1999, directing the agency to improve the quality, safety, efficiency, and effectiveness of health care while training the next generation of health services researchers. It also designated AHRQ as the nation’s lead agency for primary care research. No other agency in HHS serves this role. NIH studies disease. FDA evaluates drugs and devices. CDC tracks disease. CMS pays for care. AHRQ studies how care is actually delivered and how to make it better. Congress did not simply appropriate money for AHRQ. It established the agency’s mission in law.

If an agency created and funded by Congress can no longer carry out that mission, it raises an important question about Congress’s responsibility to oversee the laws it has enacted.

Next week, I will walk back into the neonatal intensive care unit. The babies I care for deserve the best evidence we can offer, not just the best intentions. Their parents assume the treatments we recommend are based on careful study, that hospitals are constantly learning how to provide safer care, and that someone is asking whether we can do better. They trust that our health care system is learning, even if they never see how that learning happens.

Those assumptions are not accidents. They are the product of decades of careful work by people committed to learning from every patient, so the next patient receives better care. Reasonable people can disagree about the size of government or the best way to organize health care. But we should all agree that decisions about health care should be guided by evidence.

A nation that spends more than $5 trillion each year on health care should invest in understanding what works, what doesn’t, and how to do better.

That was the promise behind AHRQ.

It’s a promise worth keeping.

This post was written by member and researcher, Stephen W. Patrick, M.D., M.P.H.

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Beginning on July 15, AHRQ issued termination notices for at least 150 active research and training grants, disrupting studies focused on patient safety, chronic disease management, care delivery improvement, digital health, and workforce development. Across these projects, researchers report losing years of investment, research staff, clinical partnerships, and opportunities to answer questions directly relevant to patients, providers, and policymakers.

Patient Safety and Preventing Harm

Patient safety remains one of AHRQ’s stated priorities, with the agency emphasizing efforts to reduce preventable harm and improve the quality of care delivered across the health system. Yet among the grants terminated this summer were several patient safety projects that embodied the kinds of rigorous, solution-oriented research AHRQ says it seeks to support.

Many of the terminated projects focused on improving how care is delivered, helping health systems identify practical ways to make care safer, more effective, and more patient-centered. Recent analyses of the canceled awards found that many used the types of rigorous study designs and intervention-based approaches that align with AHRQ’s own stated funding priorities, raising questions about why projects already generating actionable evidence were halted.

As health care leaders increasingly emphasize the need for a stronger “culture of safety” and greater transparency around medical errors, AHRQ-funded researchers were testing practical strategies to reduce preventable harm in real world settings. One such project, led by Michelle Kelly, M.D., Ph.D., examined whether giving families easier access to their hospitalized child’s medical records could help identify safety concerns before they became serious events.

The findings were already promising. Under usual care, only about six percent of families accessed inpatient clinical notes. In a pilot study, Kelly’s intervention increased that number to 98 percent. Approximately one in five participating families identified a potential medical error or safety concern, with most concerns later confirmed by clinical teams. Yet the trial ended before researchers could determine whether the intervention should become standard practice in children’s hospitals nationwide.

Similarly, Anuj Dalal, M.D., was testing digital tools designed to support patients after discharge from the hospital, a period widely recognized as one of the most vulnerable transitions in health care. The project would have allowed patients to report symptoms and concerns from home while helping clinical teams identify problems before they became emergencies. The termination halted efforts to determine which patients benefit most from remote monitoring and how health systems can better prevent avoidable complications after hospitalization.

Improving Chronic Disease Care Through Better Communication

AHRQ-funded researchers were also studying practical ways to help patients better manage chronic conditions, a major driver of hospitalizations, emergency department visits, and health care spending.

The importance of effective communication in health care received renewed attention this month when a new study found that patients who receive care in the same language they speak at home experience significantly better long-term outcomes. Researchers found that care delivered in a patient’s preferred language care was associated with a substantially lower risk of death, underscoring the role that communication, trust, and understanding can play in managing chronic health conditions.

Those findings highlight the significance of an AHRQ-funded clinical trial led by Lisa DeCamp, M.D., MSPH, at the University of Colorado. Her study evaluated telehealth-based asthma navigation for Medicaid-insured children whose families communicate in health care in languages other than English. Although effective treatments for asthma exist, many families face barriers to understanding care plans, managing medications, navigating referrals, and accessing follow-up care.

Early signs suggested the intervention was making a difference. One family told researchers that their child had previously been treated in the emergency department nearly every month for asthma but had not returned since enrolling in the program. Other families reported that, after working with an asthma navigator, they finally understood their child’s asthma action plan, leading to fewer symptoms and allowing children to participate more fully in school activities and sports. Despite those encouraging results, funding ended before the trial could be completed.

Communication barriers were also central to the work of Elaine Khoong, M.D., M.S., whose study sought to improve blood pressure control among English, Spanish, and Chinese-speaking patients receiving care in safety-net health systems. The project provided patients with home blood pressure monitors, educational resources, and support designed to help them manage hypertension outside of traditional clinic visits.

Researchers spent more than three years developing partnerships and launching the trial, only to see it terminated during patient enrollment. Early findings suggested that approximately one-third of participants entering the intervention were beginning to achieve blood pressure control. The cancellation halted data collection before researchers could determine whether the approach could improve outcomes and be adopted more broadly by safety-net health systems.

The termination also affected Amy Waterman, Ph.D., whose research focused on helping patients with advanced kidney disease prepare for transplantation before reaching kidney failure. Her team developed tools to identify patients at highest risk and provide earlier education about transplant options and living donation. With health systems preparing to test the intervention across multiple care sites, funding interruptions forced the team to scale back operations and threatened the future of the project before its full impact could be evaluated.

The Answers We May Never Get

Together, these projects illustrate a central feature of AHRQ-funded research. They were designed to generate practical evidence about how to make health care safer, more effective, and more responsive to patients’ needs. From helping families identify potential medical errors and supporting patients after hospital discharge to improving chronic disease management and expanding access to care across language barriers, these studies sought to answer questions health systems face every day.

The immediate losses include research staff positions, clinical partnerships, years of data collection, and interrupted studies. The longer-term loss may be harder to measure. In many cases, these projects were already producing promising results and generating insights that could have informed health care delivery nationwide. With the studies halted, patients, providers, health systems, and policymakers may never receive the answers they were designed to provide.

This post was written by AcademyHealth Communications Fellow, Karina Collins.

We do know that screening works, however. If it’s caught early enough, while the disease is still local, the five-year survival rate is about 95 percent. The United States Preventive Services Task Force (USPSTF) lowered the age at which universal screening should begin to 45 in 2021, meaning that all insurance covers the procedure with no out-of-pocket costs.

Unfortunately, too many Americans don’t make use of this benefit. While half of those diagnosed with colorectal cancer under 50 are between 45 and 49 (i.e. eligible for screening), only about 37 of them get screened. Because of this, about 75 percent of colorectal cancers picked up in adults under 50 are at an advanced stage, and outcomes for that aren’t nearly as good.

The evidence base isn’t the issue; the delivery system is. The research that might focus on how to do a better job was just canceled by the Trump administration.

Hannah Arem is a researcher at MedStar Health. She was in charge of a randomized controlled trial running in primary care clinics in Maryland and Washington, D.C. Her intervention involved patient navigation, one of the most promising tools for converting recommendations into practice. She wrote to us that her program was set up to “help people who express barriers to colorectal cancer screening complete screening using an evidence-based program of patient navigation.”

The grant supporting this work was one of more than 150 that AHRQ suddenly canceled in July. Along with her work, more than $130 million in committed research funding was eliminated. Her study won’t be finished, and neither clinics nor patients will get the answers they need.

Grant cancellations are only part of the story, though. AHRQ also staffs the USPSTF, the volunteer panel of experts who deliberate and decide on what recommendations to issue and what grade to give them. The Task Force hasn’t met since March 2025. Meetings have been postponed repeatedly, and in May, both the chair and vice chair were fired, leaving eight of the sixteen seats on the committee unfilled. So many draft recommendations are floating in limbo, because there are no meetings to advance them. And pretty much all of the AHRQ staff who support the USPSTF have left or been fired. I’ve written more about the USPSTF firings and the ongoing effort to undermine the generation of evidence.

Colorectal cancer rates are climbing in younger adults. The panel that would update recommendations on screening can’t meet. The research that might inform future updates has been canceled. The staff who kept all of it running are gone.

These aren’t separate stories. The whole evidence infrastructure is being dismantled.

The worst part is we don’t even know why. AHRQ makes almost no public statements about what it’s doing anymore. The only thing we really have to go on are the termination letters, which claim that these moves are all about redirecting resources towards their priorities, like telehealth and prevention. But how do we take that seriously?

And Arem’s wasn’t the only preventive care grant to be abruptly canceled.

Annie Larson had a career development award looking at how telehealth affects the use of preventive services among rural, low-income patients. Right in the sweet spot of the agency’s listed priorities. Canceled.

Nadja Vielot had a career development award focusing on whether recommending the HPV vaccination at age 9 could reduce the rural-urban gap in receiving a vaccine that prevents a number of cancers. Preventing chronic disease in rural America could not be more aligned with priorities. Canceled.

Both grants also appear in the first post in this series, on what rural communities stand to lose. Other grants doing important preventative care work relate to improving postpartum engagement in primary care among individuals with chronic medical conditions and improving asthma management for children whose families communicate in a language other than English. I could go on and on (and have). The pattern isn’t different for prevention.

The direct losses are somewhat easily measured. There are the trials that won’t finish, the money and time wasted on answers we won’t get. But there are larger losses to consider. Career development awards are how promising young researchers like Larson and Vielot build a lasting portfolio of research to improve prevention. These abrupt cancellations not only potentially derail their careers, but convince future scientists not to try.

The technology behind screening and preventing cancer gets better every year. The way we deliver it isn’t. The cancers we fail to prevent won’t show up for years, and when they do, too few people will connect them to a stack of termination letters sent in the summer of 2026.

That’s the bitterest irony. All of this work is designed to prevent suffering. This suffering is preventable, too.

In Today’s Issue:

• NIH Restricts Funding for Policy-Focused Research

• New CMS Waiver Rules Could Reshape Medicaid Coverage and State Innovation

• Vaccine-Makers Unlikely to Split MMR Shots Despite Trump’s Push

• HIV Prevention Funding Cuts Create Uncertainty for Florida Clinics

• Stricter State Laws Slow Health Care Private Equity Deals

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NIH Restricts Funding for Policy-Focused Research

The U.S. National Institutes of Health (NIH) is removing policy-focused grant projects from the agency’s portfolio because the agency claims that “policymakers are not considered a stakeholder group within the scope of NIH’s mission.” For decades, the NIH has invested in many projects examining the health impacts of policies to help policymakers make informed decisions. Freezing policy-focused grant applications would limit evidence that shape policy decisions.

According to NIH officials, many grant applicants have been instructed to remove the word ‘policy’ from their applications. NIH leadership also described certain flagged proposals as lobbying, which is prohibited under NIH rules. This change may be the result of major budget cuts under the Trump administration that may have forced the agency to shift funds away from policy-related research. Although it is normal for agency priorities to shift and evolve under different presidential administrations, excluding policymakers from “NIH mission-relevant stakeholder groups” hinders the translation of evidence into policies that could improve health care access and quality. Given the potential growing influence of political appointees in the grantmaking process, this change could further politicize NIH funding decisions especially if policy-related research conflicts with the Trump administration’s agenda.

New CMS Waiver Rules Could Reshape Medicaid Coverage and State Innovation

A new dispute over Arkansas’ Medicaid expansion waiver is raising broader questions about how the administration plans to implement new Medicaid budget-neutrality requirements established under H.R.1. According to KFF Health News, CMS recently informed Arkansas that it would not approve the state’s requested five-year waiver renewal because the program does not meet the administration’s revised interpretation of budget neutrality rules, meaning they cannot cost the federal government more than the state would have spent under standard Medicaid rules.

Medicaid waivers are designed to give states flexibility to test new approaches to coverage and care delivery, often serving as policy laboratories for innovations that federal law would not otherwise permit. States have used waivers to expand coverage, provide housing and nutrition support, purchase private insurance for Medicaid beneficiaries, create behavioral health and substance use treatment programs, and test new payment and delivery models. The decision could affect roughly 200,000 Arkansans and may foreshadow challenges for other states relying on long-standing Medicaid waivers to expand coverage, test new delivery models, or provide services beyond traditional Medicaid benefits.

The issue extends beyond Arkansas. Nearly every state operates at least one Medicaid waiver, and several states, including California and Georgia, have major waivers scheduled for renewal this year. CMS argues the new policy simply enforces statutory requirements that federal waivers not increase program costs. Critics, however, contend that the administration is using a technical budget rule to limit coverage expansions and reduce federal Medicaid spending. Hospitals and policy experts have also expressed concern that additional waiver restrictions could discourage innovation, jeopardize funding streams that support care for vulnerable populations, and create new administrative hurdles for states.

For decades, Medicaid waivers have allowed researchers to study how different approaches affect coverage, access, costs, and health outcomes. As states prepare to implement Medicaid work requirements beginning in 2027, Georgia’s Pathways program and Arkansas’ private option model are already attracting national attention as evidence for what may happen elsewhere. Changes to waiver approval and renewal processes could influence not only coverage and benefits, but also the ability of policymakers and researchers to evaluate new approaches to improving care for Medicaid beneficiaries.

Vaccine-Makers Unlikely to Split MMR Shots Despite Trump’s Push

President Trump signed an executive order directing federal officials to develop plans within 90 days to separate combination vaccines, including the measles, mumps and rubella (MMR) vaccine, into individual shots and to consider spacing out other childhood vaccinations. Implementing the changes would require manufacturers to develop and seek FDA approval for vaccines that have not been widely used individually in the U.S. for decades, potentially requiring new studies, manufacturing capacity and regulatory review. For families and providers, separating the two-dose MMR series alone could mean six office visits instead of two because spacing out additional vaccines could further increase the number of appointments needed.

For health services researchers, the proposed changes raise important questions about access, care delivery, and implementation. More required appointments could increase costs and administrative demands for health systems and pediatric practices while creating additional barriers for families trying to complete recommended vaccinations. Researchers will have an important role in evaluating how changes to vaccine delivery affect vaccination completion, access to care, provider capacity, costs and disparities across patient populations. The executive order itself does not require manufacturers to develop individual vaccines or states to change school vaccination requirements, so its ultimate impact will depend on how federal agencies, manufacturers and states respond.

HIV Prevention Funding Cuts Create Uncertainty for Florida Clinics

Community-based HIV prevention organizations in Florida are preparing to lose direct federal funding after the Trump administration announced that the Centers for Disease Control and Prevention (CDC) will not renew a grant program supporting 96 HIV-focused community organizations nationwide. According to reporting from Central Florida Public Media, the funding has supported HIV testing, outreach, education, and access to prevention medications such as PrEP, particularly in communities with high rates of new HIV diagnoses.

The decision could have significant implications for Florida, which recorded more than 4,400 new HIV diagnoses in 2024 and receives the second-largest amount of CDC HIV prevention funding nationwide. Orange County, one of the CDC’s 48 priority jurisdictions for HIV prevention, reported 423 new HIV diagnoses in 2024 and currently receives approximately $5 million annually for HIV testing and prevention efforts. While CDC has established a temporary supplemental funding stream for state health departments through May 2027, community organizations will no longer receive funding directly and instead may need to compete for state-administered grants. Advocates warn that the transition could create funding gaps and service disruptions for organizations that provide frontline prevention and testing services. The policy shift also marks a notable departure from the first Trump administration’s 2019 “Ending the HIV Epidemic” initiative, which set a goal of reducing new HIV infections by 90 percent by 2030.

The funding changes raise important questions about how public health programs are structured, delivered, and evaluated. Community-based organizations have long served as a key component of HIV prevention efforts, especially in high-incidence areas. As funding responsibility shifts from direct federal support to state-administered programs, researchers and policymakers will be watching closely to understand how the change affects access to prevention services.

Stricter State Laws Slow Health Care Private Equity Deals

Private health equity investments in health care services have been declining in recent years due to state laws imposing stricter oversight on private equity deals. The number of private equity deals dropped from 1,312 deals in 2021 to just 337 deals in the first half of 2026. A new report suggests that increased regulations and oversight discourage private equity dealmaking. For example, a new California law requires private equity firms to provide 90 days’ advance notice of proposed deals, which increases the state’s oversight on these transactions. Another law in Oregon, Senate Bill 951, restricts private equity involvement in physician practices by banning the management structures that private equity firms rely on to own and manage them. These laws could make it harder and longer for private equity firms to complete deals.

Concerns about the impact of private health equity investments on health care costs and quality have fueled increased regulatory oversight. There is a growing body of research that suggests private health equity investments can increase costs and lower quality of care. This is a pivotal example of how health services research can provide evidence to inform policy and regulations. The debate surrounding private equity in health care will continue to gain attention in the upcoming elections, and policymakers will need to lean on evidence to support their positions and determine the appropriate level of oversight.

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The timing is significant. Last week, new research found that rural patients continue to use telehealth at lower rates than urban patients despite facing greater barriers to care and higher burdens of chronic disease. At the same time, policymakers are investing billions through the Rural Health Transformation Program to address workforce shortages, hospital closures, and persistent access challenges across rural America. The program was created through H.R. 1, which paired a $50 billion investment in rural health transformation with far larger reductions to Medicaid and other health programs. Researchers have warned that those cuts could reduce the capacity of rural hospitals, community health centers, and other providers to deliver care, making it even more important to understand which interventions are most effective in strengthening rural health systems.

Many of the canceled AHRQ-funded projects were designed to tackle those same problems.

Maternal Health and Rural Emergency Preparedness

As rural hospitals continue to close labor and delivery units, researchers have warned that pregnant patients are increasingly likely to receive care from clinicians without specialized obstetric training. Andrea Shields, M.D., M.S. at the University of Connecticut School of Medicine, was leading two AHRQ-funded projects designed to address this gap by training paramedics, first responders, and non-obstetric clinicians to recognize and manage life-threatening emergencies during pregnancy, childbirth, and the postpartum period.

The training had already led to tangible changes in practice. Ambulance protocols in Arizona were updated to include medications used to treat severe maternal bleeding, a maternal transport team serving six states adopted new equipment to manage postpartum hemorrhage, and the Indian Health Service in Arizona embraced the curriculum as part of its training efforts. Planned trainings for the Navajo Nation and other underserved communities were also in development. Shields reported that care teams who completed the training have already used the skills they learned to help save the lives of pregnant patients experiencing cardiac arrest. The grant cancellations also halted data collection, disrupted research staff positions and clinical partnerships, and stopped efforts to adapt the curriculum for low-resource communities disproportionately affected by rising maternal mortality. As a result, work that was already expanding into rural and remote areas is now indefinitely delayed.

Telehealth and Rural Care Delivery

Just days after a new study reported that telehealth utilization continues to lag in rural areas despite ongoing provider shortages and access challenges, the cancellation of Annie Larson Ph.D, M.P.H.’s research highlights how many questions remain unanswered. At OCHIN, a national network of safety-net clinics, Larson was studying how telehealth affected preventive care use and quality of care among rural, low-income populations, with a particular focus on how rurality and the COVID-19 pandemic shaped access patterns.

The project never moved forward after a promised Notice of Award was not issued. Early findings suggested that telehealth use in safety-net settings was driven primarily by audio-only visits, not video visits, for both rural and urban patients. For many low-income and rural patients, audio-only telehealth can be the only practical option, particularly when broadband access, cellular coverage, digital literacy, or access to video-enabled devices is limited. Those findings raise important questions as policymakers invest heavily in rural digital health infrastructure and debate the future of telehealth reimbursement and regulation. Without studies like Larson’s, health systems and policymakers may have less evidence to guide decisions about which telehealth strategies are most effective for patients facing broadband, transportation, and access barriers.

Beyond telehealth, other canceled projects examined broader changes in rural health care delivery. At Northeastern University, Brady Post, Ph.D., was studying how hospital-physician integration affects access to care, care coordination, and health outcomes in rural and urban communities. The project comes as policymakers and health system leaders grapple with ongoing consolidation across the health care sector. According to Bipartisan Policy Center, only 32 percent of hospitals now operate independently, down from about 90 percent in 1970, and researchers continue to debate whether consolidation improves care coordination and helps struggling rural providers survive or instead leads to higher costs and reduced access to care.

Post’s research was designed to help answer those questions. The findings could have informed policies aimed at ensuring rural patients benefit from changes in the health care marketplace while avoiding unintended consequences. With the project canceled, policymakers lose an opportunity to better understand how one of the most significant trends in health care delivery is affecting rural communities.

Rural Health Research and Prevention

At Vanderbilt University Medical Center in Tennessee, Tom Reese PharmD, Ph.D. was leading an early-career research project focused on improving patient-centered decision-making for opioid use disorder treatment. The cancellation of Dr. Reese’s project comes as lawmakers from both parties are seeking to strengthen rural responses to the opioid crisis. This week, Senators Shelley Moore Capito (R-WV) and Peter Welch (D-VT) introduced legislation to preserve the Rural Communities Opioid Response Program (RCORP), which supports prevention, treatment, and recovery services in rural communities. Reese’s project focused on helping patients become active partners in decisions about opioid use disorder treatment, with the goal of improving engagement and long-term retention in care. As policymakers look for ways to expand access to treatment in rural areas, the loss of research on what helps patients stay connected to care weakens the evidence available to guide those efforts.

The cancellations also extended to research designed to address longstanding health disparities in rural communities. At the University of North Carolina at Chapel Hill, Nadja Vielot, Ph.D., was developing and testing strategies to increase HPV vaccination among rural adolescents. The project examined whether recommending the HPV vaccine at age 9, rather than waiting until ages 11 or 12, could improve vaccine completion rates and help reduce urban-rural disparities in HPV-related cancers. The research comes at a time when new studies continue to document significant geographic variation in HPV vaccination rates and highlight the need for targeted strategies to improve uptake, particularly in states and regions that continue to lag behind national goals. By identifying effective approaches to increase vaccination in rural communities, the project aimed to reduce disparities in preventive care and lower the long-term burden of HPV-related cancers. At a time when policymakers, health systems, and public health officials continue searching for ways to improve preventive care in underserved communities, the loss of research focused specifically on rural cancer prevention leaves important questions unanswered.

These stories highlight a growing disconnect between national conversations about strengthening rural health care and the loss of research designed to inform those efforts. From maternal emergency preparedness and telehealth access to substance use disorder treatment, these projects were generating evidence about how to solve some of rural America’s most pressing health challenges. Now that those studies have abruptly ended, communities lose more than research dollars and the time and money already invested. They lose opportunities to learn what works, improve care, and support better outcomes for the patients who need it most.

This post was written by AcademyHealth Communications Fellow, Karina Collins.

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The question is worth asking because the non-continuations were accompanied by a rationale. The letters state that AHRQ is realigning its portfolio toward a set of agency priorities. The priorities page the letters cite goes further, distinguishing research it favors from research it does not. It supports work focused on scientifically valid, measurable outcomes and solution-oriented approaches to disparities, and it disfavors work it characterizes as methodologically weak or as invoking poorly measured factors without defined variables. Two implicit standards are embedded there. One is a standard of scientific rigor. The other is a standard for when disparities research is legitimate. Both can be checked against the awards themselves, because we have the abstracts and public health relevance statements for the 150 awards that were not continued and for the 36 that received fiscal year 2026 funding.

When comparing these two groups of grants, it is clear that these standards fail. The way they fail is instructive in understanding how AHRQ views research

Consider rigor first. If the operative criterion were methodological strength, the awards that survived should be stronger by design than the awards that were cut. The reverse is closer to the truth. Among the 150 non-continued awards, roughly two in five describe a randomized or quasi-experimental design in their own text, including cluster-randomized trials, stepped-wedge designs, and studies exploiting randomized payment models. Because a randomized trial splits people into groups purely by chance, the groups end up similar in every way, including in variables that researchers did not think to measure. That means that if one group performs significantly better, we can be confident that the treatment caused it. Among the 36 awards that received funding, a smaller share do. The non-continued portfolio includes some of the strongest study designs the field produces. Whatever separated the two groups, a preference for rigor does not describe it, and a claim that these cuts served rigorous science cannot be reconciled with the cancelation of the most rigorous trials, such as a forty-hospital cluster-randomized trial.

The disparities standard is equally illuminating. There is a real distinction between disparities research that names a mechanism and tests an intervention and disparities research that documents a gap and attributes it to diffuse causes. AHRQ’s priorities page endorses the former and disfavors the latter. If that distinction were the operative screen, we would expect the non-continued awards to fall on the disfavored side--description without intervention, structural attribution without measurable variables.

They do not. Among the non-continued awards, the large majority that engage disparities at all do so in exactly the terms the priorities page says it favors. Nearly all of them pair the disparity with an intervention, an implementation strategy, or a trial. They are, by the agency’s own stated standard, the good kind. What distinguishes the non-continued awards from the funded ones is not the character of their disparities work but the mere presence of disparities language. It appears in a large share of the awards that were cut and a small share of the awards that were kept. The favored-versus-disfavored distinction the page draws does not track the outcomes. The presence-versus-absence of the vocabulary does.

This is where precision matters, and where it warrants being careful about what the evidence supports. These are patterns in the composition of two sets of awards. They are consistent with a screen that operated on the surface vocabulary of a project rather than on its methods or its design, sweeping in the solution-oriented, intervention-based disparities research the agency’s own standard protects. They are consistent with that, but they do not prove it. The agency’s deliberations are not publicly available, and the classification here rests on the language of the awards, which is a proxy for their content and not a substitute for reading each one. The finding is that the stated standards do not fit the observed pattern, not that any particular alternative standard was applied. AHRQ published a distinction between rigorous and weak science, and between solution-oriented and merely descriptive disparities work. It then did not continue a body of research that sits, on the evidence available, largely on the favored side of both lines. An agency is entitled to change its priorities. It is harder to defend the proposition that these particular awards failed the particular standards the agency articulated, because on the awards’ own terms, many of them meet those standards well.

The ambiguity in the letters’ language does real work here. The phrase about measurable outcomes and solution-oriented disparities research can be read as an inclusive statement of what AHRQ supports or as a set of conditions research must satisfy. Read inclusively, it describes most of the non-continued portfolio, which then cannot have been cut for failing it. Read as a filter, it is a filter the non-continued awards largely pass. The letters do not say which reading governs, and the pattern does not resolve the ambiguity so much as expose it. Under either reading, the stated criterion does not explain the outcome.

None of this establishes intent, and this post does not claim to. What it claims is narrower. When an agency offers reasons for a consequential action, those reasons can be checked against the action, and here they do not hold. The awards that were not continued are not, on the evidence, methodologically weak awards or ideologically framed awards the stated rationales guard against. That leaves an open question about what criterion actually operated, and it is a question worth pressing, in oversight and in the field’s own accounting of what was lost.

The companion white paper documents the “how” of these non-continuations and the regulatory requirements they engage. This is an accompanying question of what the pattern suggests, offered in that spirit--not as an accusation, but as an observation that the reasons given do not fit the record, and that the discrepancy deserves an answer.

This post was written by AcademyHealth’s Chief Programs & Science Officer, Elizabeth Cope.

Behind every canceled grant are patients waiting for better care, clinicians looking for evidence to guide decisions, health systems working to improve outcomes, and researchers who have spent years building partnerships and generating knowledge designed to solve real world problems.

After AHRQ grants were terminated, AcademyHealth invited affected researchers to share what these cancellations have meant for their work. Their stories describe not only what their projects were designed to accomplish, but also what has already been lost and what may never be realized if this research cannot continue.

Together, their stories reveal a consistent message. These projects were already making progress and stopping them carries consequences that will be felt long after the funding ends.

Research That Was Already Improving Care

The canceled projects addressed some of the most pressing challenges facing the U.S. health care system.

These projects were designed to address real challenges facing patients, clinicians, and health systems every day. Their work focused on improving care coordination, strengthening emergency preparedness, expanding access to preventive and evidence based care, reducing medical errors, and giving clinicians better tools to care for their patients. Researchers were also working to improve care for children with complex medical conditions, older adults with multiple chronic conditions, pregnant and postpartum patients, people living with hypertension and chronic kidney disease, Medicare Medicaid beneficiaries, and individuals transitioning from hospital to home. Other projects sought to strengthen learning health systems, improve informed consent for research participants, and train the next generation of health services researchers.

The responses make clear that this work was not sitting on a shelf waiting to begin. Clinical trials were already underway, patients had enrolled, partnerships with hospitals and community organizations had been established, and years of planning had already been translated into action. Researchers described studies that were actively testing interventions, evaluating new models of care, and generating evidence that could help health systems make better decisions. In many cases, these projects were designed to produce findings that could be implemented quickly in real world health care settings.

Many researchers also shared examples demonstrating that their work was already making a difference. They described helping patients overcome barriers to colorectal cancer screening, improving emergency preparedness by training clinicians to care for pregnant and postpartum patients, strengthening asthma and hypertension management, and providing health systems with new tools to improve care delivery. Some organizations had already begun incorporating these approaches into routine practice. When funding was terminated, that progress came to a halt. Patient recruitment stopped, data analysis paused, research teams were disrupted, and years of investment were put at risk. These stories demonstrate that the consequences extend far beyond individual research projects. They represent delayed evidence, lost opportunities to improve care, and innovations that may never reach the patients and communities they were intended to serve.

Looking Ahead

The stories shared by these researchers reveal something larger than the loss of individual grants. They demonstrate how health services research depends on sustained investment, trusted partnerships, and the time required to answer complex questions about how care can be improved. Unlike research that can be paused and easily restarted, many health services research projects rely on relationships with patients, clinicians, hospitals, and community organizations that take years to build. When funding ends unexpectedly, those partnerships can be disrupted in ways that are difficult to restore.

The responses also highlight the broader impact on the health care workforce. Researchers described losing staff, delaying opportunities for trainees and early career investigators, and putting promising careers on hold. Health services research is not only about generating evidence today. It is also about preparing the next generation of researchers who will continue improving health care tomorrow. Interrupting that pipeline has consequences that extend well beyond a single project or funding cycle.

At the same time, these stories remind us that the value of health services research is often measured in practical improvements that patients may never see happening behind the scenes. Better care coordination, safer hospital care, improved emergency preparedness, stronger chronic disease management, and more effective health system practices all depend on evidence generated through this work. When that evidence is delayed, so too are the improvements that patients, clinicians, and communities depend on.

AcademyHealth remains committed to documenting the real world impact of these funding cancellations, bringing transparency to what is being lost, and ensuring policymakers, journalists, and the public understand what is at stake. By collecting and sharing these stories, we hope to illustrate not only what has been interrupted, but also why protecting health services research matters for everyone who relies on a stronger, safer, and more effective health care system.

If you believe evidence should continue to shape better health and better health care, please consider making a gift to support AcademyHealth. Your donation helps us continue documenting these losses, amplifying researchers’ stories, creating resources that bring transparency to the field, and advocating for the future of health services research. Together, we can help ensure that the evidence patients, clinicians, and policymakers depend on remains visible, valued, and protected.

If you would like to support AcademyHealth’s work, please make a donation here.

This post was written by AcademyHealth Marketing Associate, Alondra Sandoval.

This episode of Health Care Pain Points focuses on how we talk about health care spending and why better communication matters. Dr. Aaron Carroll explores common mistakes, like assuming higher spending automatically means better outcomes, ignoring different timeframes for change, and presenting uncertainty as certainty, and show how those mistakes erode trust with patients, providers, and policymakers.

Better communication would embrace complexity, be frank about trade-offs, connect policy debates to real experiences, and resist turning every issue into a partisan identity test. That kind of honesty builds trust and creates space for longer-term strategies that actually improve health. Join Healthcare Triage and AcademyHealth in cutting through the noise by sharing this video. If we want better solutions, we need better conversations.

You can find all videos in this series here.

In this issue:

• AHRQ Grant Cancellations Continue to Draw National Attention

• U.S. Leadership in Research and Discovery Is Under Threat

• Senate Funding Deal Would Block OMB Research Rule—For Now

• 340B Debate Intensifies as CMS and HRSA Advance Competing Reform Strategies

• Court Allows Medicaid Work Requirement Rollout to Proceed Amid Ongoing Legal Challenge

• ACA Enrollment Decline Raises Questions About Affordability and Fraud

• Medical Schools Grapple With AI Scribes

• CMS Health Tech Ecosystem Expands Interoperability Efforts

AHRQ Grant Cancellations Continue to Draw National Attention

As AcademyHealth continues documenting the impact of AHRQ grant cancellations, our analysis and advocacy have been featured in national media outlets examining the growing disruption to the nation’s health services research enterprise. AcademyHealth President and CEO Aaron Carroll emphasized that these decisions affect not only researchers, but also patients, health systems, and the evidence needed to improve care.

Recent coverage includes:

• Trump administration has quietly throttled an agency devoted to the safety of American healthcare (CBS News)

  • Highlights concerns about the ongoing dismantling of AHRQ, including grant cancellations, staffing reductions, and the broader implications for patient safety research, health care quality, and evidence-based decision-making.

• Group Says AHRQ Grant Cancellations Top $131M Across 28 States (Inside Higher Ed)

  • “When these cancellations started, there was no public accounting of what was being lost, so we built one,” AcademyHealth CEO Aaron Carroll told Inside Higher Ed. “A tally can’t fully capture the impact. This funding trained the next generation of researchers and studied how to make care safer and more affordable, much of it in the very areas AHRQ said it wanted to protect.”

• Tracker Tallies Over $250M in Cancelled Grants from HHS Agency

  • Features AcademyHealth’s tracking of AHRQ grant cancellations and funding losses, documenting how disruptions to the agency are affecting researchers, institutions, and the nation’s health services research infrastructure.
    

    Check out our tracker, which captures the widespread impact of the grant cancellations here.

340B Debate Intensifies as CMS and HRSA Advance Competing Reform Strategies

Federal efforts to reform the 340B Drug Pricing Program, which requires drugmakers to provide upfront discounts on outpatient medications to eligible safety-net hospitals and clinics, accelerated this month as both CMS and HRSA advanced proposals that could significantly reshape how the program operates. CMS recently proposed cutting Medicare payments to hospitals for drugs purchased through the 340B program by more than one-third. Currently, Medicare generally pays hospitals the drug’s average market price plus an additional 6 percent. Under the proposal, Medicare would instead pay the average market price minus 33.4 percent. CMS argues that updated data show hospitals are purchasing these drugs at heavily discounted prices and that Medicare is currently reimbursing hospitals at rates well above what they paid for the medications. At the same time, HRSA announced it will move forward with a revised 340B Rebate Model Pilot Program, which would replace upfront discounts for certain drugs with manufacturer-issued rebates beginning in 2027.

Supporters of these changes, including pharmaceutical manufacturers, argue that both the reimbursement reduction and rebate model would improve transparency, strengthen program integrity, and better align payments with actual acquisition costs. Hospitals and safety net providers counter that the proposals could increase administrative burden, create cash flow challenges, and reduce resources they rely on to provide care in underserved communities. Since Medicare payment changes must be implemented in a budget neutral fashion, some stakeholders have also noted that reductions to 340B hospitals could result in increased payments elsewhere in the system.

The 340B debate is increasingly driven by competing interpretations of the evidence, with both manufacturers and provider groups citing research to support their positions. AcademyHealth’s A Decisionmaker’s Guide to Competing Health Evidence: The 340B Drug Pricing Program examines what we know about payment-based reforms, how different policy approaches affect hospitals and patients, and what lessons can be drawn from past 340B disputes. Researchers and policymakers looking to understand the competing claims surrounding recent CMS and HRSA actions can start with the guide here.

Court Allows Medicaid Work Requirement Rollout to Proceed Amid Ongoing Legal Challenge

A federal judge has denied a request from 26 states to temporarily block portions of CMS’ Medicaid work requirement implementation rule, allowing the current rollout timeline to remain in place while broader legal challenges continue. The states argued that recent guidance, particularly changes to how beneficiaries qualify for the medical frailty exemption, would create significant administrative burdens and increase the risk of eligible individuals losing coverage.

The ruling comes as states race to meet federal implementation deadlines and finalize systems for identifying individuals who should be exempt from work requirements. While the court declined to halt the rule, it did not rule on the merits of the states’ broader challenge, which remains ongoing.

Evidence from previous Medicaid work requirement demonstrations suggests that administrative processes can be just as important as eligibility rules in determining who loses coverage. For health services researchers, the implementation of medical frailty exemptions presents an important opportunity to study how policy design, administrative burden, and state implementation choices affect enrollment, access to care, health outcomes, and health equity.

For a deeper look at how CMS’ medical frailty guidance could affect vulnerable populations and state implementation efforts, read AcademyHealth Research Associate Brianna Bragg’s analysis, The Medical Frailty Crisis: How Rushed Implementation Threatens Medicaid’s Most Vulnerable, here.

Medical Schools Respond to Rise of AI Scribes

As AI scribes become more common in clinical settings, medical schools are wrestling with when and how trainees should use them. STAT News reports that educators want future physicians to understand AI tools but are concerned that relying on them too early could interfere with the development of clinical reasoning and documentation skills.

Institutions are taking different approaches, from restricting AI scribes during early training to developing customized tools and requiring students to complete portions of their work independently. The variation highlights a broader evidence gap: AI adoption is moving faster than research on its effects on medical education and clinical practice.

For health services researchers, that creates important questions about how AI-enabled tools affect training, workflow, care delivery, patient outcomes, and the skills clinicians need to practice safely and effectively.

Join AcademyHealth at Health Datapalooza this September 24-25 to have more conversations about the role of AI and the future of health care delivery. Learn more here.

The U.S.’s Global Leadership in Research and Discovery is Under Threat

In a recent BMJ commentary, Lucinda Hiam, a 2025-26 Harkness fellow, highlighted that one of the greatest strengths of the U.S. health care system lies in its global leadership in research and discovery. She argues that this strength rests on a broad ecosystem spanning federally funded research institutes, universities, biotechnology, philanthropy, clinicians, and patients and that the system is now under threat.

Hiam points to two distinct threats: the administration’s proposed changes to federal grantmaking that could give political appointees greater influence over research funding, and the cancellation or withholding of already appropriated AHRQ grants. She notes that the latter reflects a broader struggle between Congress, which appropriated the funding on a bipartisan basis, and the administration, which has declined to release it.

“For all its contradictions, America’s health system risks losing one of the few things it has excelled at: the ability to generate evidence, innovation, and new treatments.”

Hiam spoke with AcademyHealth Director of Advocacy Josh Caplan while reporting the piece.

Senate Bipartisan Funding Deal to Avoid Shutdown and Delay OMB Rule

On Sunday, Senate leaders introduced a bipartisan continuing resolution to keep federal agencies funded at current levels through December 11 to avoid government shutdown during the campaign season. The House passed a similar funding measure, but the Senate bill excludes the administration’s $1 billion request to support the proposed “Trump-class” battleships and blocks the transfer of money from other programs to the Border Patrol. This short-term funding extension would give more time for Congress to negotiate full-year spending plans as Republicans seek to increase defense spending by 44 percent and cut non-defense programs by 10 percent.

The bipartisan government funding bill would delay the implementation of the proposed OMB rule from October 1 until at least December 11. The rule, if implemented, would politicize the grantmaking process by allowing political actors to influence what research is funded, how it is carried out, and how results are interpreted and communicated. This rule would fundamentally threaten the scientific integrity and independence that are critical to America’s research infrastructure.

The Senate’s continuing resolution bill is an important milestone to delay the detrimental effects of the proposed OMB rule. However, the fight is far from over. The Senate is expected to vote on the bill this week, and any differences between the House and Senate bills must be resolved before it reaches the president’s desk and becomes law.

CMS Expands Health Tech Ecosystem with New Interoperability Initiatives

One year after launching the CMS Health Tech Ecosystem, CMS announced eight new initiatives to expand health data interoperability and reduce administrative burden across the health care system. The initiatives include price transparency, real-time insurance benefits, modern scheduling, clinical trial matching, Bulk FHIR for population health and research, pharmacy data exchange, the ACCESS program, and efforts to make diagnostic imaging easier to share across providers. CMS also reported significant progress in giving patients greater access to their health records through third-party apps, while acknowledging that broader provider adoption and continued interoperability improvements will be needed to fully realize these goals.

For the health services research community, he expansion of interoperable data infrastructure creates new opportunities—and new questions. Better access to claims, clinical, and patient-generated data could strengthen research on health care quality, care delivery, implementation, and outcomes, but researchers will also need to assess whether these technologies actually reduce administrative burden, improve care, and deliver value for patients.

With health data policy and technology evolving rapidly, there has never been a more important time to convene researchers, policymakers, innovators, and patients. Health Datapalooza 2026, taking place September 24-25 in Washington, D.C., will bring together leaders from across the health data ecosystem for practical, evidence-driven discussions on interoperability, AI, digital health, and the policies shaping the future of health care. Register today to be part of the conversation.

Kennedy, Oz Contend Fraud Crackdown, Not Skyrocketing Prices, Led Millions To Leave Obamacare

In a Department of Health and Human Services report released in June, Affordable Care Act enrollment fell by nearly three million people, from more than 22 million individuals enrolled in ACA plans in 2025 to about 19.2 million as of February 2026. According to KFF, average monthly premium payment increased by 58 percent while annual deductibles increased by 37 percent from last year. The Trump administration argues that the recent decline in ACA enrollment is the result of its fraud control efforts, not rising insurance costs. However, many health policy experts disputed this claim and attributed the loss of coverage to sharp increases in premiums and deductibles.

As the Trump administration continues to strengthen its anti-fraud efforts, policy experts questioned whether fraud is the primary reason millions of Americans lose coverage. Policy analysts claimed that the Trump administration overstated the extent of ACA fraud based on questionable assumptions. Additionally, some experts worry that the blur distinction between fraud, administrative errors, and policy disagreements can lead to misleading claims about the scope of fraud. Aggressive anti-fraud measures may increase administrative burdens and create barriers to enrollment, which may result in many eligible individuals losing health care coverage. With the midterm elections approaching, health care costs will be a key debate topic with Democrats focusing on affordability while Republicans emphasizing anti-fraud measures.

State Medicaid agencies now face the difficult task of building individualized medical frailty assessment systems while simultaneously preparing to launch work requirements on a fixed federal timeline. The challenge is not merely administrative—evidence from previous Medicaid work requirement demonstrations suggests that implementation choices can determine whether eligible individuals maintain coverage.

As referenced in AcademyHealth’s recent Decisionmaker’s Guide to Competing Health Evidence edition, Arkansas’ 2018 implementation of work requirements is our closest real-world parallel, and the results were stark. Thousands lost coverage, employment did not rise, and studies found that most who lost coverage were actually qualified yet failed to navigate the reporting requirements to prove it. The interim rule’s medical frailty provisions create even more complex hurdles, which begs a critical question: how will people with serious medical conditions navigate an even more demanding system while simultaneously managing their illnesses?

Earlier this year, Medicaid Medical Directors writing in JAMA Health Forum argued that successful implementation would require operational flexibility, diverse data sources, and streamlined administrative processes. The interim final rule instead emphasizes individualized determinations over the operational flexibility many state Medicaid leaders had recommended.

When Vague Definitions Meet Implementation Reality

Although “medical frailty” has existed in Medicaid policy before, it has historically been used in the context of expanding access to care. Under H.R. 1, the same concept now determines who can avoid losing coverage, raising the stakes of how states define and operationalize the exemption.

H.R.1’s work requirements included medical frailty exemptions with five categories. Four of these categories were straightforward and aligned with existing disability frameworks that states already used for identification purposes. Recipients of Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) would be exempt, as would those with “disabling” mental disorders or physical, intellectual, or developmental disabilities that significantly impair activities of daily living.

The fifth category, individuals with a “serious or complex medical condition,” introduced significant ambiguity, creating one of the most pressing implementation challenges states now face. When CMS’ preliminary guidance in December failed to provide clarity, states seeking to meet the January 2027 deadline had to move forward with implementation plans regardless. An early 2026 survey revealed most states planned to use Medicaid claims data to verify medical frailty, with some identifying specific diagnostic and service codes and 30 states hoping to allow people to self-attest to frailty when verification data are not available.

Rather than allowing states to identify medically frail individuals based on qualifying diagnoses or existing clinical criteria, the June interim final rule requires states to determine whether each individual’s specific condition prevents them from meeting the work requirement. States may still develop lists of relevant health conditions, but those conditions cannot automatically qualify someone for an exemption.

Upending State Plans

The mandate for individual assessments creates a significant administrative burden for states, forcing states to rethink systems for individualized review. This guidance, provided six months in advance of the deadline, not only adds to the already substantial costs associated with building these systems but also exacerbates challenges for health departments already operating under strained capacities. Further, the interim final rule significantly restricts states’ ability to accept self-attestation of frailty. While this will be temporarily permitted through 2027, individuals are still required to provide full documentation at their six-month renewal.

Nebraska, who launched its program in May eight months ahead of the deadline, relied on their near 300-page index of diagnosis and procedure codes and self-attestation process to identify individuals who would qualify as medically frail. Under the new CMS guidance, they now must re-work their system since they cannot categorically exempt individuals.

The Human Impact

Evidence from prior Medicaid work requirement demonstrations suggests that administrative design can have substantial consequences. As seen in Arkansas, people fall through the cracks when navigating bureaucracy to prove they qualify for the exemption. Even without work requirements, the Medicaid system writ large is riddled with obstacles for beneficiaries. A survey of Medicaid recipients revealed one in three respondents encountered difficulties at enrollment and one in four at renewal, citing barriers like long wait times, complex paperwork, and inadequate communication systems. Notably, Medicaid enrollees not only report difficulties with their insurance but are also more likely to experience declines in health or unmet treatment needs due to these issues compared to those with other forms of coverage.

The interim rule introduces even more complex administrative steps that demand the most from those with the least to give, especially since the population at risk for enrollment has a high prevalence of chronic and potentially function-limiting conditions. Sick individuals must gather energy their illnesses have stolen and navigate systems with resources they don’t have to prove they are worthy of health care. The interim rule’s case-by-case assessments could force work requirements on:

• A cancer patient between treatments, still struggling with debilitating fatigue

• People with autoimmune diseases like lupus or rheumatoid arthritis whose symptoms flare unpredictably

• Unhoused individuals with serious conditions but no consistent medical provider

• Rural residents with chronic pain who can’t reach specialists for proper diagnosis

A Call to Action

When these individuals lose coverage, they lose access to the very treatments keeping their conditions manageable, leading to a cascade of preventable suffering.

The window for course correction is closing. With the interim final rule’s comment period ending tomorrow July 31, CMS needs to hear from researchers, providers, and advocates about why these medical frailty provisions will fail to protect our must vulnerable patients and why states need more time to build functioning systems.

In today’s issue:

• Putting the Full Cost of AHRQ Grant Cancellations on the Record

• The Courts Stopped the 15 Percent Cap. The Fight Over Research Overhead Is Just Beginning.

• Voices from the Field: The Human Cost of Workforce Reductions

• The Administration Proposes Major Shift in Federal Research Funding Priorities

• Health Care Faces Congressional Oversight Heading into 2026 Midterms

• Former FDA Official Calls for Review of Federal Response to Cyclospora Outbreak

• Senate Health Panel Delays Vote on Erica Schwartz to Run CDC

Putting the Full Cost of AHRQ Grant Cancellations on the Record

This week, AcademyHealth launched Research Interrupted, a public tracker documenting the AHRQ research grants that have been canceled, the people and communities those projects were intended to serve, and the potential health care improvements now at risk.

Since July 15, AHRQ has canceled funding for more than 100 health services research grants across 28 states, representing more than $200 million in research. Until now, there hasn’t been a single public source showing the scope of what has been lost. AcademyHealth’s Research Interrupted resource brings that information together in one place.

The tracker documents verified grant cancellations, what each project was working to accomplish, and who stood to benefit. It gives researchers, policymakers, reporters, and the public a way to see the full picture and the collective impact of dismantling the nation’s only federal agency dedicated to health services research. AcademyHealth is offering a clear, public record of what’s happening to the field and the research enterprise. If your work has been interrupted, please email us at advocacy@academyhealth.org

Explore and share the tracker: researchinterrupted.academyhealth.org

The Courts Stopped the 15 Percent Cap. The Fight Over Research Overhead Is Just Beginning.

A year after the administration’s proposed 15 percent cap on research overhead triggered lawsuits across the country, the courts have weighed in, but the policy debate is only getting started. Congress, OMB, and the research community are now advancing competing visions for how the federal government should pay for the infrastructure behind scientific research. While the administration has pushed for tighter limits on indirect costs, many research organizations have rallied around the FAIR (Financial Accountability in Research) model, an alternative framework that seeks to increase transparency and accountability in research infrastructure funding while preserving the capacity universities need to conduct federally funded research.

In the latest edition of A Decisionmaker’s Guide to Competing Health Evidence, AcademyHealth examines the evidence behind the debate, explains why stakeholders are often arguing about different problems entirely, and offers a framework for evaluating the administration’s proposals alongside the research community’s FAIR model. If you’re trying to understand what comes next for federal research funding, this guide is a useful place to start.

A Decisionmaker’s Guide to Competing Health Evidence is a monthly series from AcademyHealth. Each edition takes a live policy debate, explains the structure of the disagreement, and gives readers the tools to evaluate the evidence themselves. Please note, each edition reflects the evidence as it existed at the time of publication. Feedback submitted within 30 days of publication will be reviewed and, when warranted, we may update the decisionmakers guide while clearly noting what changed and why.

Voices from the Field: The Human Cost of Workforce Reductions

In the latest reflection for Work Interrupted: Voices from the Field, Karen Yao shares a deeply personal account of navigating job loss, postpartum depression, financial uncertainty, and the loss of professional identity following a major reduction in force. As a viral immunology researcher, she had spent years building a career in science, only to find herself unexpectedly starting over while caring for a newborn and rebuilding a future she thought was secure.

Karen’s story is a powerful reminder that workforce reductions are never just organizational decisions. Behind every eliminated position is a person, a family, and years of expertise. At a time when public health and scientific institutions continue to face disruption, her reflection challenges us to look beyond budgets and staffing numbers and consider the human cost of these changes. Read her reflection here.

The Administration Proposes Major Shift in Federal Research Funding Priorities

The administration has outlined a proposed overhaul of the federal research enterprise, signaling a shift in funding priorities toward artificial intelligence, robotics, nuclear energy, and other emerging technologies. Speaking before the House Science Committee, White House science adviser Michael Kratsios described the current research system as overdue for reform, arguing that federal investments should be more closely tied to measurable outcomes and national priorities. The proposal would reduce reliance on the long-standing model in which universities conduct federally funded research and instead place greater emphasis on funding individual investigators and private sector organizations.

The report, Science: A New Golden Age, also suggests that federal agencies prioritize what it calls “foundational research” while placing less emphasis on portions of the life sciences research enterprise. Supporters argue the changes could accelerate innovation and strengthen U.S. competitiveness in rapidly evolving fields such as artificial intelligence and advanced computing. Critics, however, have raised concerns that shifting resources away from universities and biomedical research could weaken the research infrastructure responsible for many of the nation’s scientific and medical breakthroughs. Lawmakers also questioned how the proposal aligns with recent grant cancellations, staffing reductions at federal science agencies, and broader efforts to increase political oversight of federal research funding.

For the health services research community, this proposal comes amid ongoing disruptions to federal research funding and growing concerns about the future of agencies like AHRQ. AcademyHealth has been tracking AHRQ funding delays, grant cancellations, staffing reductions, and their effects on the nation’s evidence infrastructure. Together, these developments suggest a broader shift away from longstanding federal investments in health services and biomedical research and toward a new model centered on technological priorities and private-sector innovation.

Health Care Faces Congressional Oversight Heading into 2026 Midterms

With the midterm elections gradually approaching and Democrats hoping to win majorities in the 120^th Congress, many congressional staff members have already started preparing oversight agendas into major health care topics. Congressional oversight efforts are expected to focus heavily on private sector entities, meaning companies, consultants, and trade associations that interact with the Trump administration could face congressional inquiries in the coming months.

While affordability, health care costs, consolidation, and fraud will remain a priority, investigations are expected to expand to include private equity and financialization of healthcare, artificial intelligence and health care data, perceived conflicts of interest and ethics concerns, and federal contracts and health care funding. These investigations may include matters such as medical debt, hospital acquisitions and closures, AI-assisted prior authorization, data protection practices, and federal contracting decisions. Additionally, Democrats may investigate negotiations between health care companies and the Trump administration on matters such as drug pricing negotiations, Medicare pricing models, and pharmaceutical trade and tariff policies.

As Congress considers investigations into major health care topics, the demand for rigorous, policy-relevant evidence is likely to grow. Congressional investigations may rely on empirical research addressing key oversight topics to assess how these issues impact costs, quality, and access to care. This emphasizes the critical role of health services research in influencing policy change and shaping public debate. However, ongoing funding cuts threaten the capacity of health services researchers to generate timely evidence to inform policymaking. Continued investment in health services research is essential to ensure health care policy decisions are informed by sound evidence.

Former FDA Official Calls for Review of Federal Response to Cyclospora Outbreak

A former senior Food and Drug Administration (FDA) official is calling for an independent review of the federal government’s response to the ongoing Cyclospora outbreak, which has sickened thousands of people across the country. Frank Yiannas, who served as FDA Deputy Commissioner under both the Trump and Biden administrations, criticized what he described as a lack of federal leadership and coordination as public health agencies continue investigating multiple outbreaks linked to contaminated food products.

Cyclospora is a foodborne parasite that causes an intestinal illness known as cyclosporiasis, which can lead to prolonged diarrhea, nausea, fatigue, and other gastrointestinal symptoms. As of July, more than 4,000 laboratory-confirmed cases and hundreds of hospitalizations have been reported, with thousands of additional suspected cases under review. Investigations have focused on several potential sources, including a multistate outbreak associated with iceberg lettuce, though questions remain about how public agencies communicated findings and managed recalls.

Yiannas’s comments come amid scrutiny of federal food safety systems and growing concern about whether public health agencies have the staffing, resources, and coordination mechanisms needed to respond effectively to large-scale outbreaks. Foodborne disease outbreaks offer important opportunities to evaluate how public health surveillance systems identify threats, communicate risks, and coordinate responses across agencies and states.

Senate Health Panel Delays Vote on Erica Schwartz to run CDC

The Senate Committee on Health, Education, Labor, and Pensions (HELP) delayed its vote on Erica Schwartz’s nomination to lead the Centers for Disease Control and Prevention (CDC) after attendance issues prevented the committee from reaching a vote. The committee also postponed consideration of Sean Kaufman, the nominee for assistant secretary for preparedness and response, leaving two key federal public health leadership positions unfilled as the administration continues to fill senior health roles.

For the health services research community, these delays extend uncertainty around the leadership that will guide the nation’s public health priorities, emergency preparedness strategy, and implementation of CDC initiatives. While procedural rather than policy driven, prolonged vacancies in senior public health positions can slow decision making, delay strategic planning, and create uncertainty for agencies, researchers, and public health partners that rely on consistent federal leadership to advance evidence-based public health programs and preparedness efforts.

Since then, I’ve noticed another theme emerging in coverage of the Task Force. The debate is increasingly framed as a choice between a panel that has been too slow and too cautious, and a new approach that promises more preventive care for more Americans. It’s an appealing argument because prevention is one of the few things almost everyone agrees on. Who wouldn’t want to detect disease earlier? Who wouldn’t want to prevent illness before it starts?

Those are the right goals. But they are not the question the Task Force was created to answer.

Prevention Is Only Helpful If It Helps

Preventive care has transformed medicine. Vaccinations, blood pressure screening, colorectal cancer screening, tobacco cessation counseling, and many other preventive services have saved lives and improved health for millions of Americans. We should absolutely want more preventive care when the evidence shows it works.

The challenge is that prevention is not automatically beneficial simply because it happens earlier. Screening healthy people is fundamentally different from treating someone who is already sick. Screening tests can save lives, but they also carry risks: false positives, unnecessary procedures, overdiagnosis, anxiety, and treatments for conditions that may never have caused harm. Detecting a disease earlier does not necessarily mean a person lives longer or healthier. Sometimes it does. Sometimes it doesn’t.

That is why preventive medicine demands such a high standard of evidence. Before recommending that millions of healthy people undergo a screening test, we have to answer a deceptively simple question: does this improve health enough to outweigh the harms?

That answer cannot come from instinct, optimism, or even good intentions. It has to come from evidence.

What the Task Force Actually Does

One of the biggest misconceptions about the USPSTF is that it decides which preventive services Americans should receive. In reality, it sits at the end of a much longer scientific process.

Researchers conduct clinical studies over many years. The Agency for Healthcare Research and Quality supports Evidence-based Practice Centers that systematically review the entire body of published research on a topic. Those reviews are then presented to the Task Force, whose members evaluate the quality of the evidence, weigh the benefits and harms of screening, solicit public comment, and ultimately issue recommendations.

By the time a recommendation reaches the Task Force, years (sometimes decades) of scientific work have already taken place.

This is why one phrase appears so often in Task Force recommendations: “the current evidence is insufficient.”

To many people, that sounds like indecision or unnecessary caution. In science, it means something very different. It means researchers have not yet generated enough high-quality evidence to answer the question with confidence.

That isn’t a failure of the Task Force. It’s the conclusion the evidence supports.

Evidence Changes Recommendations

If that sounds frustrating, it should. Patients living with devastating diseases understandably want answers as quickly as possible. Physicians want better tools. Advocacy organizations want more options for the communities they serve.

Science, however, doesn’t move because we want an answer. It moves because new evidence changes what we know.

We’ve seen that happen repeatedly throughout the Task Force’s history. In 2021, after new research showed rising rates of colorectal cancer among younger adults and demonstrated that earlier screening could improve outcomes, the Task Force lowered the recommended age for routine colorectal cancer screening from 50 to 45. That recommendation expanded access to preventive care for millions of Americans. It happened because the evidence changed, not because the Task Force adopted a different philosophy or lowered its standards.

The evidence can move recommendations in the other direction, too. In 2012, after large trials showed that routine PSA screening for prostate cancer prevented few deaths while producing substantial overdiagnosis and treatment harms, the Task Force recommended against it. In 2018, with longer follow-up data and better approaches to managing low-risk cancers, it revised that position and recommended that men aged 55 to 69 make an individual decision with their clinicians. Neither change reflected a new philosophy. Both reflected a change in what we knew.

That is how evidence-based medicine is supposed to work. Researchers ask important questions. Studies are conducted. Evidence accumulates. Recommendations evolve.

Why the Current Debate Matters

Many of the diseases now receiving attention deserve more research. Alzheimer’s disease affects millions of families. Chronic kidney disease remains a major public health challenge. New technologies for detecting cancer are advancing rapidly and hold tremendous promise.

None of that is in dispute.

What concerns me is the growing suggestion that if the Task Force isn’t recommending enough preventive services, the solution is to replace the people evaluating the evidence with people who are more willing to reach different conclusions.

If decades of research have not yet answered an important clinical question, replacing the reviewers does not create new science. That may produce more recommendations, but it does not necessarily produce better ones.

Why Independence Matters

I’ve also seen calls for the Task Force to include more specialists representing particular diseases and conditions. Specialists are indispensable to the process. They conduct much of the research the Task Force reviews. They identify emerging questions. They provide public comment and clinical expertise throughout the development of recommendations.

But the Task Force was never intended to function as a collection of disease advocates.

Every specialty quite naturally wants to improve outcomes for the patients it serves. Every patient advocacy organization wants more attention devoted to the condition it fights every day. Companies developing new diagnostic technologies believe their innovations deserve consideration. Those perspectives are valuable, and they belong in the conversation.

The Task Force has a different responsibility. Its job is to step back from those individual perspectives and ask a broader question: given everything we could recommend to healthy Americans, which preventive services have sufficient evidence to improve health across the population?

That distinction matters. Every disease is important. Every patient population deserves better care. Every promising technology comes with compelling stories about the lives it could change. The Task Force exists because someone has to evaluate all of those claims according to the same evidentiary standard.

Without that common standard, recommendations inevitably become influenced by which diseases have the strongest advocates, the most persuasive stories, or the greatest commercial interest behind them.

If We Want More Prevention, There’s a Better Path

If our national goal is to expand effective preventive care, there is a straightforward way to do it: Invest in the evidence.

Fund the clinical trials that answer unresolved questions. Strengthen AHRQ and the Evidence-based Practice Centers that synthesize the research. Allow the Task Force to meet regularly, deliberate publicly, and evaluate new evidence as it emerges. Support the researchers whose work ultimately determines whether a promising idea becomes a recommended preventive service.

None of those steps guarantees that a particular screening test will receive a favorable recommendation. That is exactly as it should be.

Science begins with a question, not an answer. Research exists to determine what works, not to validate what we hope is true. When the evidence changes, recommendations should follow. If the evidence hasn’t changed, we should be honest enough to say so.

The value of the Task Force has never been that it recommends more preventive care. Its value is that clinicians and patients can trust that its recommendations are driven by evidence rather than enthusiasm, commercial interest, or political preference.

Those recommendations will always disappoint someone. Some advocates will believe they move too slowly. Others will think they go too far. That’s inevitable when the standard is evidence rather than preference.

We want recommendations that people can trust because they followed the evidence wherever it led, even when the answer was, “we don’t know yet.”

Aaron gets candid about the trade-offs. Prevention improves health but rarely pays off immediately, and changing payment or pricing structures creates winners and losers. The result is a system where fixing one problem often shifts pressure elsewhere. This episode gives clear, evidence-based explanations that you can use in briefings, classrooms, or family conversations about health outcomes. Watch the full explainer and share it to help move the conversation from noise to useful solutions.

You can find all videos in this series here.

In today’s issue:

• Judge Rules Against Use of Obscure Clause to Cancel Grants to States

• AcademyHealth Continues to Raise the Alarm on AHRQ Grant Cancellation

• AHRQ Watch: AcademyHealth in the News

• CMS Questions the Future of CPT Coding and Physician Payment

• States Begin Adjusting to Medicaid Funding Reductions
  

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Judge Rules Against Use of Obscure Clause to Cancel Grants to States

On July 17, U.S. District Judge Indira Talwani in Boston ruled that the Trump administration could not use a provision in federal grant regulations to justify the funding cuts at issue in the case. The provision, part of the federal government’s Uniform Guidance for federal grants, allows an agency to terminate a grant if the award “no longer effectuates the program goals or agency priorities.”

Judge Indira Talwani rejected the administration’s interpretation, finding that it was inconsistent with the regulatory framework governing federal grants and the constitutional requirements governing federal spending. The decision has implications far beyond a single grant as recent grant terminations have affected scientific research, education, crime prevention, environmental programs, and food security.

The ruling came after 23 states sued the Trump administration over its decision to cut $11 billion in federal funding for medical research and public health programs. The decision also comes amid the recent AHRQ grant cancellations, in which awards were terminated to “better prioritize agency resources” and align with AHRQ’s current priorities.

For the research community, this ruling marks a significant victory because it protects the integrity and transparency of the federal grantmaking process. However, the broader debate over agency authority to terminate grants and political influence in federal funding decisions will likely continue in the coming months. With nearly 500,000 comments submitted in response to the Office of Management and Budget’s proposed grantmaking rule, additional legal challenges may be forthcoming to safeguard the independence and stability of federal research funding.

AcademyHealth Continues to Raise the Alarm on AHRQ Grant Cancellation

On July 15, AHRQ began issuing grant termination notices to researchers across the country, ending support for training programs and ongoing studies focused on cancer care, hospital-acquired infections, vaccination, telehealth, and other efforts to improve health care quality and patient safety. AcademyHealth has been at the forefront of tracking these cancellations, briefing congressional offices on their potential impact, and supporting affected researchers as they navigate this disruption. Our Situation Report provides timely updates on the scope of the cancellations, outlines actions the health services research community can take in response, and highlights the potential implications for the nation’s research infrastructure. Read the full report here.

The recent AHRQ grant cancellations are part of a broader pattern of fund impoundment that began on April 5, 2025. In yesterday’s Situation Report, we reflect on a series of unprecedented actions over last year, including the continued impoundment of AHRQ funds, the collapse of the agency’s grantmaking infrastructure, the pending GAO investigation, the firing of USPSTF’s leadership, and the response from AcademyHealth and the broader health services research community to protect AHRQ’s grantmaking capacity and scientific independence.

AHRQ Watch: AcademyHealth in the News

As AcademyHealth continues documenting the impact of AHRQ grant cancellations, our analysis and advocacy have been featured in national media outlets covering the growing disruption to the nation’s health services research enterprise. AcademyHealth President and CEO Aaron Carroll emphasized that these decisions affect not only researchers, but also patients, health systems, and the evidence needed to improve care.

Recent coverage includes:

• HHS research agency ends funding for dozens of health studies (CQ Roll Call)
  Features AcademyHealth’s estimate that at least 67 AHRQ grants have been canceled and Aaron Carroll’s warning that years of investment, staffing, and patient recruitment are being lost.

• Trump Administration Cuts Off Health Care Research Grants Without Warning (NOTUS)
  Highlights AcademyHealth’s concern that vastly different research projects received nearly identical explanations for cancellation, raising questions about how decisions were made.

• Health department abruptly cancels health research grants worth millions (Politico PRO)
  Reports on AcademyHealth’s estimate that more than $60 million in committed AHRQ funding has been canceled and the broad consequences for researchers, institutions, and patients.

CMS Questions the Future of CPT Coding and Physician Payment

The Centers for Medicare & Medicaid Services (CMS) is reconsidering the federal government’s longstanding reliance on the American Medical Association’s (AMA) Current Procedural Terminology (CPT) code set and the Relative Value Scale Update Committee (RUC) as part of the proposed 2027 Medicare Physician Fee Schedule. While CMS is not proposing immediate changes, the agency is seeking public comments on whether the current coding and valuation process supports patient-centered care, prevention, and evolving models of health care delivery. The request also asks whether alternative approaches outside of the AMA could improve transparency, reduce administrative complexity, and better align payment with federal health priorities.

For health services research, the discussion extends well beyond coding. Payment systems shape clinical practice, resource allocation, data collection, and the evidence available to evaluate health care delivery. Any changes to how services are defined or valued could affects research, quality measurement, reimbursement analyses, and comparisons across providers and health systems. Health services researchers are well positioned to evaluate how coding and payment policies influence care delivery, provider behavior, and patient outcomes, while generating evidence to inform future reforms based on what’s best for Americans interacting with the health care system rather than political oversight.

Senate Allows Medicare AI Prior Authorization Pilot to Continue

The Senate voted 46-50 to reject an effort to halt CMS’ Wasteful and Inappropriate Service Reduction (WISeR) Model, allowing the six‑year Medicare pilot to continue in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. The model applies prior authorization and prepayment review to a select group of services that CMS considers vulnerable to fraud, waste, abuse, or inappropriate use, including certain orthopedic procedures, implanted devices, and skin substitute treatments.

WISeR uses artificial intelligence and machine learning tools to assist with utilization review, while requiring a qualified clinician to review any proposed non‑approval. CMS argues the model will reduce unnecessary spending, improve program integrity, and speed decision-making. Critics, however, believe that AI supported prior authorization could create new barriers to care, reduce transparency, and potentially influence clinical decision making in ways that are difficult for patients and providers to understand or challenge.

Lawmakers from both parties have increasingly scrutinized the use of AI in prior authorization by Medicare Advantage and commercial insurers, citing concerns about inappropriate denials, transparency, and accountability. Yet the Senate voted largely along party lines to preserve a CMS initiative that applies AI-assisted review within traditional Medicare. The result underscores growing debate over whether AI supported utilization management should be judged differently when deployed by public programs versus private insurers.

The WISeR model creates an important opportunity to evaluate how AI-assisted prior authorization affects patient access, health outcomes, administrative burden, and health care spending. Researchers can help determine whether AI-supported review reduces inappropriate utilization without delaying medically necessary care, while also examining how oversight, transparency, and appeals processes function in practice.

Engage in conversations about the role of AI in health care at our Health Datapalooza conference this September. Learn more here.

States Begin Adjusting to Medicaid Funding Reductions

The proposed Medicaid funding reductions are beginning to reshape how states provide long-term services and supports, with several states moving to reduce payments for family caregivers as they prepare for lower federal Medicaid funding in 2027. In Maryland, officials have proposed significant wage cuts for family caregivers of people with disabilities, prompting advocates to warn that many families could face financial hardship or be forced to place loved ones in institutional care. Similar proposals in states including Idaho, Indiana, Missouri, and Colorado suggest these types of reductions may become more common as states adjust to lower federal Medicaid funding, particularly by scaling back home and community-based services, which are optional under Medicaid.

For health services researchers, these developments raise important questions about how Medicaid funding decisions affect access to care, health outcomes, and costs across the health system. As states make different policy choices, researchers will have opportunities to study how reductions in home and community-based services influence caregiver financial stability, workforce participation, institutionalization rates, emergency department use, hospitalizations, and Medicaid spending over time.

The changes also highlight the need for stronger evidence on the effectiveness and return on investment of self-directed care models, as well as the broader value of home and community-based services in helping people with disabilities remain safely in their homes. That evidence can help policymakers better understand the tradeoffs between short-term budget reductions and the potential long-term impacts on patients, caregivers, and the health care system.

Last week, AHRQ announced the cancelation of nearly every grant that it had previously awarded, from training grants for the next generation of researchers to studies that sought to tackle hospital acquired infections, barriers to cancer screening, improving patient capacity, helping children with asthma get care, helping providers recognize child abuse, and so much more. We have been notified of nearly 80 canceled representing more than $200 million in taxpayer investments in improving American health care is being thrown away.

Since April 1, 2025, AHRQ has not issued a single new research grant, and ongoing projects have also ground to a halt. An estimated 80 percent of AHRQ’s staff is no longer at the Agency due to actions taken by the Trump administration, including the entirety of the staff overseeing the extramural grant program that reviews, issues awards, and manages federal investments, as well as nearly all staff supporting the U.S. Preventive Services Task Force, dissemination and communication efforts, and intragovernmental experts. With the catastrophic loss of personnel, it is impossible for AHRQ to fulfill its mission in making health care more accessible, higher value, and affordable. When promising ideas remain unfunded or are disrupted part of the way through, the devastating effects ripple through the entire health care system.

AHRQ Funding Impoundment

Congress has authorized and appropriated funds for AHRQ to support research on health care quality, patient safety, and health care delivery. In FY 2025, AHRQ received $345 million in appropriated funds from Congress, yet policy decisions made by the administration meant that $80 million in appropriated dollars never reached researchers. Under the Impoundment Control Act of 1974, the executive branch cannot simply refuse to spend the money that Congress has appropriated because they do not agree with it. If the executive branch wants to withhold funds, it must follow specific statutory procedures, including notifying and receiving approval from Congress.

Following operational and staffing changes in 2025, AHRQ has stopped issuing new and continuing grants. Since September 2025, AHRQ has released only $13 million in noncompetitive continuing grants, barely 5 percent of what Congress has appropriated for the current fiscal year. Last week, the Agency canceled nearly every grant that it had awarded, all but ensuring that it will be unable to invest nearly 90 percent of what Congress mandated. This is an illegal impoundment where appropriated funds are not obligated for the purpose authorized and funded by Congress. This blockage has effectively shut down AHRQ’s grantmaking operations, preventing the agency from carrying out its core responsibilities authorized by Congress in improving patient safety and care delivery.

The fight for AHRQ has also been taken to the courts, where the Society for General Internal Medicine has sued the Administration for the harms caused by the illegal impoundments in the FY25 funding year in the case SGIM v. Kennedy. This case is still being litigated at the motion stage, and AcademyHealth is grateful for SGIM’s leadership in taking this on.

The Dismantling of Scientific Independence

AHRQ plays a critical role in providing scientific and technical infrastructure that enables U.S. Preventive Services Task Force (USPSTF), the nation’s independent advisory body on preventive medicine, to develop recommendations on preventive services. The USPSTF meets three times a year in March, July, and November; however, it has not convened since March 2025, delaying the development of preventive care recommendations that insurers, health systems, and clinicians rely on to guide patient care and coverage decisions.

On May 11, the USPSTF’s Chair John Wong and Vice Chair Esa Davis were fired from their positions without cause. The two sitting chairs are responsible for conducting independent reviews of nominations for new Task Force members, and the unprecedented firing of USPSTF’s leadership further undermines its ability to maintain scientific independence and fill eight of sixteen vacant seats with qualified and credible experts. The deadline for nomination of USPSTF members was May 23, 2026. The July meeting has been postponed until late August; however, a date has not been publicly set for that meeting.

Protecting Research Funding and Scientific Independence

The health services research community has not remained silent. AcademyHealth leads the Friends of AHRQ, a voluntary coalition of more than 650 organizations that support and advocate for AHRQ’s funding and grantmaking infrastructure. These organizations represent research facilities, patient advocates, nursing organizations, providers, hospitals, universities, think tanks, and more. The Friends of AHRQ actively engages with Congress through letters, briefings, and policy outreach to raise awareness of the devastating effects of the AHRQ impoundments on America’s ability to generate and implement life-saving and cost-effective health interventions. The Friends successfully won in the FY26 Labor-HHS appropriations law funding for an intact, independent, and functioning AHRQ with a full extramural research program, as well as the minimum staffing needed to meet their mission.

In the current FY27 appropriations negotiations, the Friends sent to Congress a letter calling for full funding of AHRQ and a return to sufficient staffing that was signed by over 260 organizations in a record smashing show of support from across the health care system for the work that AHRQ leads. In addition to testimony submitted to the House and Senate regarding AHRQ’s funding, AcademyHealth actively engages with bipartisan congressional offices to keep them inform on the status of the agency.

AcademyHealth also worked closely with Representatives Diana DeGette (D-CO) and Doris Matsui (D-CA) to request that the Government Accountability Office (GAO) formally investigate if the impoundments were indeed unlawful. That investigation is ongoing, and we hope to see the results released at any time. Every month that appropriated funds remain unavailable is another month of lost research opportunities, layoffs of researchers, collapsing studies, and delays in scientific advancement.

Beyond leading efforts to restore funding for AHRQ, AcademyHealth has continued to champion the protection of the USPSTF. Following the sudden cancellations of USPSTF meetings in July 2025, AcademyHealth along with the Friends of AHRQ sent a letter urging Congress to protect the structure and scientific independence of the Task Force. As of today, no announcements have been made regarding who will fill the vacant positions in the Task Force, heightening the uncertainty of the future of USPSTF.

The substantial staffing cuts at AHRQ, the impoundment of funding, the removal of USPSTF leadership, and the cancellation of meetings are not isolated events. They reflect a broader pattern of actions that has dismantled the research infrastructure by collapsing the grantmaking function, delaying the development of preventive care recommendations, and undermining scientific independence. The coming months will be critical for determining the future of AHRQ. Ongoing litigations, the GAO investigation, and FY27 appropriations decisions will determine whether AHRQ can restore its grantmaking function and continue its mission of improving health care delivery, patient safety, and health care quality.

AcademyHealth will continue tracking these cancellations and documenting their impact. If your AHRQ funding has been affected, please reach out to us at advocacy@academyhealth.org.

For more than a year, AcademyHealth has warned that the Agency for Healthcare Research and Quality (AHRQ) was no longer functioning as Congress intended after mass firings and resignations under pressure left the agency with roughly 20 percent of its staff. Grant funding slowed to a halt. Researchers stopped receiving continuation awards. New projects were never launched. Despite receiving appropriated funding from Congress, the agency largely stopped investing in the research that helps make health care safer, more effective, and more affordable.

Yesterday, the situation took a significant turn.

Researchers across the country have begun receiving official notices from AHRQ informing them that continuation funding for their grants will not be awarded. While many investigators had gone months without receiving expected funding, these are the first formal notifications that ongoing projects are effectively being brought to an end. AcademyHealth is actively collecting information from researchers nationwide to understand the full scope of these actions.

What We Know So Far

While our assessment is ongoing, several patterns have already emerged:

• AcademyHealth has heard from more than 45 researchers and institutions that have received cancellation notices and additional reports continue to arrive.

• The notices span multiple types of awards, including research grants, career development awards, institutional training grants, and research infrastructure programs.

• Many recipients received nearly identical letters despite supporting very different types of research.

• Several affected projects directly address priorities AHRQ itself has publicly identified, including patient safety, antibiotic resistance, digital health, and reducing health disparities.

• Based on the information available today, these actions affect non-competing continuation funding that Congress has already appropriated.

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The affected projects are not concentrated in a single area of research. They include efforts to improve patient safety, strengthen health care delivery, reduce costs, train the next generation of researchers, and generate evidence to inform clinical practice and policy. Examples of affected work include:

• A randomized trial focused on antibiotic stewardship across 40 hospitals — directly aligned with preventing antibiotic resistance and improving patient safety.

• Research evaluating how Medicare and Medicaid policies affect vulnerable patients.

• Work examining medical debt and financial harm after illness or injury.

• Projects improving integration of behavioral health and substance use care in primary care settings.

• Training programs preparing the next generation of health services researchers.

Why This Matters

This is about much more than research funding.

The affected projects help hospitals prevent infections, improve patient safety, reduce unnecessary health care costs, train the next generation of health services researchers, evaluate new models of care, and generate the evidence clinicians and policymakers rely on every day.

When those projects stop, patients lose opportunities for better care. Health systems lose evidence they need to improve. Researchers lose years of work. And taxpayers lose the return on investments Congress has already made.

The cancellation notices also raise important questions about how these decisions were made. AcademyHealth is reviewing the notices carefully, consulting legal and policy experts, and working with congressional offices and partner organizations to understand what these actions mean and whether they are consistent with existing federal grant regulations.

What AcademyHealth Is Doing

This is exactly why AcademyHealth exists. Our goal is to keep our community informed and protect the research enterprise.

We are:

• Collecting and analyzing grant cancellation notices from across the country.

• Tracking the scope of affected awards and institutions.

• Briefing congressional offices and appropriations staff.

• Reviewing the notices with legal and policy experts to better understand the implications for researchers and the broader research enterprise. Engaging national reporters to ensure accurate coverage of what is happening.

• Coordinating with partner organizations across the research community.

• Providing researchers and policymakers with timely analysis and updates as the situation develops.

As we learn more, we will continue sharing updates through the Situation Report.

If You Received a Notice

If your AHRQ grant has been affected, we encourage you to contact us.

Please email advocacy@academyhealth.org and, if you’re willing, include:

• Your grant number

• Your institution

• The date you received the notice

• A copy of the notice

Every report helps us better understand the scope of these actions and strengthens our ability to advocate on behalf of the research community.

How You Can Help

This moment calls for the health services research community to speak with one voice.

You can help by:

• Contacting your Members of Congress and explaining what this means for your research, your institution, and the patients you serve. Sample language is below.

• Sharing your experience with AcademyHealth so we can document the national impact.

• Sharing this article with colleagues who may not yet know what’s happening.

• Supporting AcademyHealth’s advocacy efforts so we can continue responding rapidly when the evidence ecosystem is under threat.

For more than a year, AcademyHealth has worked to document the growing challenges facing AHRQ and the nation’s evidence infrastructure. We have analyzed federal grant data, met with Congressional leaders and submitted written testimony, coordinated advocacy across hundreds of organizations, supported litigation and a GAO investigation defending the agency’s statutory mission, and provided policymakers and journalists with timely analysis of developments affecting health services research.

Today’s grant cancellations represent another major turning point.

We will continue working to ensure researchers, policymakers, and the public understand not only what is happening, but why it matters for everyone who depends on better evidence to build a healthier America.

Subject: Please Protect AHRQ Research

Dear [Senator/Representative],

I am writing as a constituent to express my concern about recent actions affecting research funded by the Agency for Healthcare Research and Quality (AHRQ). Researchers across the country are receiving notices that continuation funding for ongoing projects is being canceled, despite Congress appropriating funding for the agency.

AHRQ-supported research helps improve patient safety, reduce health care costs, expand access to care, and ensure that clinicians have the evidence they need to deliver high-quality care. These projects are not abstract academic exercises—they directly improve the health care Americans receive every day.

I urge you to conduct oversight of these actions, seek transparency regarding the scope of the cancellations, and ensure that the funding Congress appropriated for AHRQ is being used consistent with the law and congressional intent.

Thank you for your leadership and your attention to this issue.