The Affordable Care Act-created research institute charged with evaluating the effectiveness of medical treatments expects to spend $3.5 billion by the end of the decade, but also faces a rising chorus of criticism about how much value it actually provides.
The Patient-Centered Outcomes Research Institute (PCORI) has spent a little more than $1 billion since 2012 on "comparative effectiveness" contracts that it awards to researchers, medical schools and advocacy groups in an effort to identify the medical interventions that best work for patients, the Center for Public Integrity reports.
Even America's Health Insurance Plans has received $500,000 to "build and maintain support from health plan leaders" and to "identify important gaps in availability of health insurance administrative data."
PCORI is funded by Medicare, general revenue and a tax on health plans, the article states. But some have started to question whether the institute's goals and accomplishments are worth the money.
A review by the Center for Public Integrity, for instance, found that PCORI spends only about 28 percent of its budget on projects that evaluate disease prevention, treatment and diagnosis. It spends more than $70 million on projects to help it improve research methods and on contracts that are "essentially public relations gestures," according to the article.
PCORI also faces various challenges related to its plans to develop a "network of networks" to pursue comparative effectiveness research, a Government Accountability Report found, including the lack of a standard data model.
Citing concerns over wasteful spending, the House Appropriations Committee in late June cut PCORI's funding by $100 million. Sen. Pat Roberts (R-Kan.) also filed a bill that would block Medicare from using the institute's results to deny or delay coverage, though the ACA already states that PCORI's findings are not mandates for "practice guidelines, coverage recommendations, payment or policy recommendations."
Yet Tony Coelho, a former Democratic congressman from California who chairs the Partnership to Improve Patient Care, said he is impressed with PCORI's efforts to "get first-hand views on what questions really matter to patients," according to the article. The institute said it has also funded some promising projects that could have widespread health ramifications, such as a $14 million study to determine how much aspirin patients should take every day to prevent heart disease.
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