Why does cost effective care spread so slowly

According to Fuchs and Millstein, here’s why: Insurers hesitation to standardize coverage.  Standardization of coverage would force insurance companies to compete primarily on the basis of price, which would put pressure on their profits. Employers bear too much of the marginal cost from employees choosing expensive health plans.  Because companies wish to avoid alienating employees,…

Who’s running the Patient-Centered Outcomes Research Institute (PCORI)?

As part of Health Reform, the government created the a center to study clinical effectiveness of different health treatments.  This center, known as the Patient-Centered Outcomes Research Institute (PCORI), “does not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment.”  What leverage does the Institute have?  Not too…

Patient Heterogeneity and Comparative Effectiveness Research

According to Kathleen Lohr, the most pressing issues for comparative effectiveness research (CER) include: 1) how to conduct CER for heterogeneous patient populations and 2) ways to implement longitudinal investigations to capture long-term health outcomes.  Today I will focus on measuring patient heterogeneity.  Although it makes sense to take into account differences across patients, measuring…