1989

Establishment of federal Agency for Health Care Policy and Research (AHCPR) with mandate to produce practice guidelines. It was a response both to need for cost containment and new data (some collected by PSROs) that revealed “ alarming discrepancies, institutional as well as regional, in the incidence of medical and especially surgical procedures” (Weisz et al., 708; J. Daly, 214). In 1999, it was recast as the Agency for Healthcare Research and Quality, which, instead of developing guidelines itself, “provided funding for a series of twelve external evidence-based practice centers to conduct systematic reviews of the evidence on topics nominated for their relevance to factors like disease prevalence, significance to health programs, and cost, as well as the availability of scientific data. This evidence could be used directly by health plans and payers, and by public and private organizations to develop practice guidelines” (J. Daly, 220-221).