Ah -- the vicissitudes of sausage making.
According to Andrew Dawson, staffer for the House Ways and Means Committee, “The final CER product - whatever comes out of the Senate, whatever comes out of the House - they are different enough that where we end up in a conference report will be somewhere in the middle."
When Mr. Dawson refers to "CER," he means Comparative Effectiveness Research -- aka cost effectiveness, aka clinical effectiveness, aka healthcare technology assessment. But it's important to recognize that these are not all synonyms. (For example, in the long ago and forgotten stimulus package, $1.1 billion was set aside for clinical effectiveness research.)
The Senate Health, Education, Labor and Pensions Committee's reform package would create a new center in the HHS Agency for Healthcare Research and Quality to oversee CER. The melded House health reform bill, unveiled Oct. 29 would also create a center within AHRQ, though supported by a combination of public and private funding and receiving advice from an independent stakeholder commission.
Another key pending issue is how research data generated by CER may be used. The House has previously added language stating explicitly that data "may not be used to deny or ration care." The Senate Finance Committee version lets CER data be used in Medicare coverage decisions, though only providing several criteria are met and a single CER study is not the only basis for a decision.
The Congressional Budget Office has scored the CER provisions of the revised House bill as lowering Medicare outlays by $100 million from 2010 through 2019, but increasing non-Medicare outlays by $1.2 billion during the same period.
How can CBO score CER studies – that (1) according to the revised House bill aren’t supposed to be used “to deny or ration care” and (2) don’t exist yet? Hmm.
According to Andrew Dawson, staffer for the House Ways and Means Committee, “The final CER product - whatever comes out of the Senate, whatever comes out of the House - they are different enough that where we end up in a conference report will be somewhere in the middle."
When Mr. Dawson refers to "CER," he means Comparative Effectiveness Research -- aka cost effectiveness, aka clinical effectiveness, aka healthcare technology assessment. But it's important to recognize that these are not all synonyms. (For example, in the long ago and forgotten stimulus package, $1.1 billion was set aside for clinical effectiveness research.)
The Senate Health, Education, Labor and Pensions Committee's reform package would create a new center in the HHS Agency for Healthcare Research and Quality to oversee CER. The melded House health reform bill, unveiled Oct. 29 would also create a center within AHRQ, though supported by a combination of public and private funding and receiving advice from an independent stakeholder commission.
Another key pending issue is how research data generated by CER may be used. The House has previously added language stating explicitly that data "may not be used to deny or ration care." The Senate Finance Committee version lets CER data be used in Medicare coverage decisions, though only providing several criteria are met and a single CER study is not the only basis for a decision.
The Congressional Budget Office has scored the CER provisions of the revised House bill as lowering Medicare outlays by $100 million from 2010 through 2019, but increasing non-Medicare outlays by $1.2 billion during the same period.
How can CBO score CER studies – that (1) according to the revised House bill aren’t supposed to be used “to deny or ration care” and (2) don’t exist yet? Hmm.
