Former USPSTF officials call on Kennedy to preserve the agency the task force relies on

Key takeaways:

• The USPSTF will likely be affected by the Agency of Healthcare Research Quality’s downsizing.
• Experts called on HHS to preserve the agency’s functions and vital staff so it can keep supporting the USPSTF.

Downsizing at HHS may affect the United States Preventive Services Task Force — a key part of maintaining the health of Americans, according to an expert.

Michael J. Barry, MD, former chair of the USPSTF, and more than 40 other former task force chairs, members and scientific directors wrote a letter to HHS Secretary Robert F. Kennedy Jr. expressing their concern about how the recent and impending cuts would impact the USPSTF.

The cuts include a downsizing of the Agency for Healthcare Research Quality (AHRQ), which the task force relies on, according to the letter.

Healio spoke with Barry to learn more about exactly how the cuts will impact the USPSTF and how both patients and providers will feel it.

Healio: Would you explain the importance of the USPSTF and the role the task force plays in our health?

Barry: Since 1984, the USPSTF has been making evidence-based recommendations about preventive health services like screenings for cancer and heart disease. For example, task force recommendations include cancer screenings for breast, colorectal and lung cancer; screening to find aortic aneurysms before they rupture; and folic acid supplements for women to prevent birth defects in their babies. The task force has recommendations that keep children, adolescents and adults healthy and that help pregnant women and their newborn babies. All of its guidance empowers patients and their primary care clinicians to decide what preventive care is right for them.

The most common causes of chronic disease in America include smoking, obesity, high blood sugar, hypertension and high cholesterol. The USPSTF has recommendations on all these issues, often for both children and adults.

Currently, the USPSTF curates 90 preventive recommendations aimed at improving the health of people across the country. Over the 40 years of the task force’s existence, hundreds of thousands, if not millions, of lives have been saved with its often-simple, inexpensive recommendations. Current law requires that most private insurers cover preventive interventions that earn the task force’s highest ratings with no charge to patients. Thus, effective preventive interventions, such as mammograms and colonoscopies, are widely available to Americans at no out-of-pocket cost.

Healio: Why did you and so many others decide to write this letter?

Barry: Our concern was specifically about the reorganization and downsizing of the AHRQ. Although the task force itself is — by design — scientifically independent, it relies on AHRQ to do its work.

The Public Health Service Act requires that this agency convenes the task force and provides scientific, administrative and dissemination support for its work. This means that without AHRQ, the task force would not be able to review the highest-quality evidence for preventive care, or to publish its findings. But more importantly, it means that without AHRQ, the task force’s recommendations could never reach the hundreds of thousands of PCPs — and their millions of patients nationwide — who use these recommendations every day.

Healio: How exactly will the USPSTF be affected by AHRQ’s consolidation? What resources might be taken away? Will recommendations be delayed?

Barry: The full implications of the reorganization and roughly 40% reduction in workforce at AHRQ are as yet unclear. We know that Secretary Kennedy focused on eliminating contracting, communications and administrative staff — but we also know that the task force relied on many AHRQ staff who performed those functions to do essential contracting and logistics work, and to ensure that task force recommendations are communicated clearly and effectively to the clinicians and patients who need to use them. I anticipate that the task force’s ability to perform its vital scientific functions and share that guidance widely will be notably hampered by these changes.

Healio: What do you hope the letter will accomplish?

Barry: Secretary Kennedy has already stated that some of the layoffs across HHS were inappropriate. We hope a careful analysis of the support functions that AHRQ provides to the task force will be undertaken and those functions will be preserved, including reinstating any key personnel who may have been put on administrative leave.

Healio: What are the letter’s most important points? What do you want to hit home the most?

Barry: The USPSTF needs many different resources at AHRQ to function effectively. For example, systematic reviews of the scientific evidence around the potential benefits and harms of preventive interventions are done through AHRQ contracts with a group of experienced Evidence-Based Practice Centers. Without those evidence reviews, the task force simply cannot do its work.

We congratulate Secretary Kennedy for his defense of the Braidwood v. Kennedy case that will be argued before the Supreme Court shortly, which challenges the link between the task force’s highest recommendations and free effective preventive care. We are also thankful to him for putting prevention of chronic diseases front and center in his agenda. However, eroding AHRQ support for the task force is as much of a threat to Secretary Kennedy’s prevention agenda and the health of people nationwide as any judicial decision might be.

We certainly hope that Secretary Kennedy will heed our concerns and make sure that AHRQ’s functions and vital staff are preserved in the reorganization so that it can continue to provide vigorous support for the task force.

Healio: Is there anything else you would like to add?

Barry: The USPSTF has been making evidence-based recommendations, free from conflicts of interest, about lifesaving preventive interventions for 40 years. Current law means people nationwide can access the most effective interventions for free. The USPSTF, in partnership with AHRQ, needs to remain at the center of any strategy designed to “Make America Healthy Again.”