The Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Department of Health and Human Services, has discontinued funding for dozens of active research grants, a move that has unsettled many researchers and raised concerns about the future of health services research in the United States.

Among those affected is Amy Waterman, a health researcher at Houston Methodist Hospital in Texas, who had spent three years developing a program aimed at improving kidney care. Her project, designed to identify patients at the highest risk for kidney failure and to inform families about early kidney transplants, was poised for implementation in several California clinics. However, on July 15, Dr. Waterman was notified that her grant would no longer receive funding, putting the continuation of her work in jeopardy.

The grants terminated by AHRQ cover a range of topics, from reducing inappropriate antibiotic use to enhancing treatments for childhood asthma. According to AcademyHealth, an organization monitoring these developments, at least 150 active grants have been discontinued, representing approximately $229 million in funding.

AHRQ typically awards multiyear grants that are disbursed in installments, contingent upon the submission of regular progress reports. While midstream termination of grants is infrequent and usually occurs for specific reasons, researchers report receiving no clear explanations in recent termination notices. The letters cited an agency decision to "adjust its award portfolio to better prioritize agency resources," listing areas such as patient safety, preventing antibiotic resistance, and digital innovation in health care as priorities. However, some recipients noted that their research aligned with these stated priorities.

Emily Hilliard, a spokeswoman for the Department of Health and Human Services, clarified that the grants were not formally terminated but rather that continuation funding was not approved after a statutory review by the agency’s director to determine if ongoing investment serves the federal government’s interests.

The cuts follow significant staff reductions at AHRQ, accompanied by decreasing grant activity and administration. Legal advocates, including attorneys from Public Citizen Litigation Group—which filed a lawsuit against AHRQ last year—have expressed concerns over the lack of transparency surrounding decision-making processes. A recent federal court ruling in Massachusetts limits the agency’s ability to terminate grants in certain states based on shifting priorities, although forthcoming legislation could alter these constraints.

The funding stoppage also affects programs dedicated to training emerging health services researchers. One such program at Brown University, which has operated continuously since 1986, has ceased recruiting new trainees despite being highlighted as an agency priority.

Affected researchers have been forced to seek alternative funding sources, including institutional support, private foundations, and other federal agencies like the National Institutes of Health (NIH). However, NIH’s focus on basic biomedical research means that the practical, community-focused work often funded by AHRQ faces added challenges.

Dr. Sebastian Tong, a University of Washington researcher, described how funding cuts halted the latter and critical phases of his project aimed at improving substance abuse care in primary care settings. With no replacement funding, his team has paused all work, despite interest from participating clinics to continue efforts without compensation.

Similarly, Dr. Nora Becker of the University of Michigan, whose research investigates the financial impact of COVID-19 on patients, reported losing funding last fall and has since been urgently applying for new grants to sustain her work.

These developments mark an unprecedented disruption in the continuity of health services research funding at AHRQ, raising questions about the future of projects that have direct implications for health care delivery and patient outcomes, especially in underserved populations.