Increasing research and information on comparative clinical effectiveness would help improve health care delivery and save Medicare dollars, according to lawmakers who addressed a hearing of the House Ways and Means Health Subcommittee on June 12, 2007. Chairman Pete Stark (D-Calif.) said rising health care costs and a lack of clinical evidence have led many to call for a federal effort to substantially increase information on the relative effectiveness of health care services. “Providing Medicare with better information about the relative strengths and weaknesses of various products, procedures and services will help public and private payers equitably and efficiently manage rising health care costs,” he said. He added that using Medicare resources effectively will help achieve the best possible patient outcomes.
“Having better information on how various treatments compare to one another will enable doctors and their patients to make informed decisions about whether new or high priced drugs, devices, and other medical treatments do or do not provide better clinical outcomes,” said Rep. Thomas Allen (D-Maine).
Allen said it would cost about $3 billion over five years to develop a system for evidence based research, adding that the funding could come from the Medicare Trust Fund, insurers, large employers and general government funds.
Allen has introduced the Enhanced Health Care Value for All Act (H.R. 2184) to build on the success of the Agency for Health Care Research and Quality’s “Effective Health Care Program” and finance new research on the comparative effectiveness of health care services. The legislation would create a public-private funding mechanism to pool federal resources with funds from health insurance plans and large employers with self-insured plans.
Rep. Jim Ramstad (R-Minn.) said he is concerned that a single comparative effectiveness authority would make determinations about what’s covered by insurance. Allen replied that the authority would not determine what is or is not covered.
Carolyn Clancy, director of the AHRQ, Rockville, Md., said that as the agency implemented the Effective Health Care program, it has learned it’s important to set clear priorities that meet the needs of all of the stakeholders in the health care system. Therefore, end users and stakeholders must continuously provide input through an open and transparent process, she said.
Ranking Republican subcommittee member Dave Camp (R-Mich.) was concerned the information could be used to limit access, as was Rep. Allyson Schwartz (D-Penn.). She wanted to make sure the information is used in the best way possible to improve patient health.
Rep. Jim McDermott (D-Wash.) said the authority would be a “toothless tiger,” with no intended impact. Allen promised that sound evidence-based information will have an impact and will drive medical decisions in an effective way.
Stark commented that if a proposal to create such an authority were under consideration, it “would scoot right through this committee.”
Source: CCH Washington Bureau, June 13, 2007.
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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