In order to speed scientific discovery and its efficient translation to patient care, the NIH developed the Roadmap for Biomedical Research. The Roadmap provides an incubator space for funding innovative programs to address a panoply of scientific challenges and has engendered a new culture of cooperation among researchers seeking new avenues for collaboration. An important feature of the Roadmap is the Clinical and Translational Science Awards (CTSA). The program's goals are to eliminate growing barriers between clinical and basic research, to address the increasing complexities involved in conducting clinical research, and to help institutions nationwide create an academic home for clinical and translational science.ACA service delivery reforms:Accountable care organizations—cooperation between provider groups and insurersBundled payments – require cooperation across hospitals and ambulatory care, specialists and primary carePCMH: What the health care system delivers and what patients often diverge: Particularly true with end of life care where over 90% of medical care services are delivered.
PCORI established in 2010--It will not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment. Medicare may take the Institute’s research into account when deciding what procedures it will cover, so long as the new research is not the sole justification and the agency allows for public inputTo examine the "relative health outcomes, clinical effectiveness, and appropriateness" of different medical treatments The law governing the Institute forbids it to develop or employ any threshold to establish what type of health care is cost effective or recommended.CCMI: Created by Congress in ACA to “test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care” for those who get Medicare, Medicaid or CHIP benefits.
UCSF CER - Intro to Stakeholder-Engaged Research (Symposium 2013)
AN INTRODUCTION TO STAKEHOLDER-ENGAGED RESEARCH Laura A. Schmidt PhD, ProfessorPhilip R. Lee Institute for Health Policy Studies, School of Medicine, UCSF
What’s the point? • Promote outcomes of medical care that are important to patients and families • Make sure stakeholders have the information needed to make relevant medical decisions • Get all the stakeholders participating and playing on the same side toward common goals
What’s the impetus? • NIH Roadmap Initiative (launched in 2004) - Promoted research translation - Successful translation inevitably means engaging stakeholders • Health Reform or Affordable Care Act of 2010 - Service delivery reforms involving multiple stakeholders - Promotes patient-centered care
Who is interested? • Patient-Centered Outcomes Research Institute (PCORI) • Agency for Healthcare Research and Quality (AHRQ) • MEDICARE (Center on Medicare and Medicaid Innovation) • FOUNDATIONS (Aetna, RWJF, Kellogg, Commonwealth) • ORGANIZED STAKEHOLDER GROUPS (AARP)
What are the opportunities? • PCORI − FY 2013 $320 million, $650 million per year (~ $3.5 billion thru FY 2019) − Majority through competitive RFP grants, some contracts • AHRQ − FY 2013 $408.8 million requested − More on patient outcomes, HIT, safety, value, prevention − Majority through contracts, some smaller investigator-initiated grant • CCMI − Annual budget in the billions − Research linked to real-world innovation experiments and demonstrations applied to federal programs (Medicare, Medicaid, CHIP, FQHCs) − 16 initiatives: comprehensive primary care, FQHCs, home-based care, payment bundling, ACOs, dual eligible, patient safety, workforce development, prevention • FOUNDATIONS − Commonwealth: Patient-centered medical homes − RWJF: Community engagement, population health − Aetna- care coordination, patient centered care, disparities