The U.S. should establish a new center for comparative effectiveness information to help make better coverage and spending decisions, Gail Wilensky, a senior fellow at Project HOPE and former administrator of the Health Care Financing Administration during the administration of George H. W. Bush, writes in a new Health Affairs article.
The new center would not make centralized coverage decisions. Instead, it would assess the comparative effectiveness of alternative therapies and all types of medical interventions for the benefit of payers, patients, and providers. The center would fund prospective trials to address gaps in effectiveness evidence and review existing research currently performed by the Agency for Healthcare Research and Quality, the Blue Cross Blue Shield Association, and other private-sector U.S. organizations, and comparative effectiveness centers in other countries. But, Wilensky warns, “Unless all major payers regard the placement and financing of such a center as being consistent with the production of objective and unbiased data, the information it produces will be of little use.”
Wilensky offers the idea of locating the new center in a type of entity called a “federally funded research and development center,” which receives the bulk of its funding from the federal government--likely the Medicare Trust Fund--and is generally sponsored by an agency--probably AHRQ. At the same time, FFRDCs can accept up to 30% of their funding from private sources, and Wilensky suggests that a small charge “could be assessed on all users, providers, or suppliers of health care services or on health plans.”
