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The Catch: The Effectiveness Research Pie

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The Patient-Centered Outcomes Research Institute (PCORI) is supposed to be spending $122 million this year on efforts to make sure that U.S. medical treatments really work and that treatment is delivered as efficiently and effectively as possible.

PCORI is developing national priorities and a research agenda; comments are due March 15.

The drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) created PCORI, with PPACA Section 6301, to fund “comparative effectiveness research.” The mission of the independent, nonprofit organization is to “fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions,” the group says.

Analysts at Avalere Health L.L.C.,Washington, a health policy firm, report that PCORI will be spending about 24% of its 2012 budget on activities such as administration, reaching out to patients, and developing research methods.

About $22 million of the $122 million research budget will go to pilot projects, and $8.8 million to developing research infrastructure.

About $36 million of the research funds will go to comparisons of prevention, diagnosis and treatment options; $18 million to studies of efforts to improve health care systems; $18 million to efforts to speed up outcomes research, and $9.1 million to efforts to address the effects of factors such as race, sex and income on health care.

If PCORI stays on track, it should have a big enough budget to make a lasting impact on comparative effective research, the Avalere analysts conclude.


The Ensigh Group Inc., Mission Viejo, Calif. (Nasdaq:ENSG), has acquired Doctors Express Inc., Baltimore.

The Ensign Group, a company that owns nursing homes, hospice care provider and assisted living facilities, recently started to diversify into the urgent business by starting an urgent care joint venture, Immediate Clinic L.L.C.

Doctors Express is a company that provides basic primary care through walk-in medical centers. Doctors Express has 49 medical centers up and running, and it has awarded a total of 143 franchises in 24 states, Ensign says.

Ensign is not saying how much it is paying for Doctors Express, but it says Doctors Express will keep its name, identity and franchise-based business strategy. Ensign will operate Doctors Express as a subsidiary of Immediate Clinic.


Dr. William Frist, the former Senate majority leader, will be the honorary chairman of a new National Commission on Physician Payment Reform.

The Society of General Internal Medicine, Washington, is starting the commission to look into topics such as accountable care organizations and value-based medicine and produce a report in early 2013.

The commission funders will include the Robert Wood Johnson Foundation, Princeton, N.J., and the working chairman will be Dr. Steven Schroeder, the former president of the Robert Wood Johnson Foundation. Schroeder is a professor in the medical school at the University of California, San Francisco.

The only commissioner who is now working in the health insurance or benefits industries is Dr. Lisa Latts. Latts is vice president for public health policy at WellPoint Inc., Indianapolis (NYSE:WLP).


Platinum Underwriters Reinsurance Inc., an affiliate of Platinum Underwriters Reinsurance Holdings Ltd., Pembroke, Bermuda, has hired Equinox Management Group Inc., Oradell, N.J., to create and be the managing general underwriter for a new excess medical reinsurance facility, the Emerald facility.


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