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Comparative Effectiveness

Why Employers Care

Comparative effectiveness research (CER) provides evidence on the effectiveness, benefits and potential harms of different medical interventions. It is designed to help health care providers and patients make informed decisions, improve care quality, prevent harms, and reduce unnecessary spending.

Understanding the relative effectiveness and efficiency of medical interventions is a national priority. The American Recovery and Reinvestment Act of 2009 or stimulus included $1.1 billion to the Agency for Health Care Research and Quality (AHRQ), the National Institutes of Health (NIH), and the Health and Human Services Office of the Secretary to evaluate the relative effectiveness of different health care services and treatment options. The law creates a Federal Coordinating Council for CER to coordinate federal action on CER and tasks the Institute of Medicine to recommend research priorities for the $1.1 billion.

The Patient Protection and Affordable Care Act includes provisions that increase CER. The Department of Health and Human Services, through the Patient-Centered Outcomes Research Institute (PCORI), will distribute CER findings to providers and the public. To fund CER, the federal government will collect an assessment on self-insured health plans as well as contribute a fee per Medicare beneficiary. More details on the fees can be found in our health reform toolkit.

In December 2012, the IRS released final regulations providing details on the types of group health plans subject to Patient-Centered Outcomes Research Trust Fund fees, how plan sponsors will calculate the fees based on the number of covered lives, and how the IRS will process fee payments. The Business Group submitted comments to PCORI recommending that they focus research efforts on overuse and inappropriate use of health services and the working age population.

What Can Employers Do?

Employers and their health plan partners can use comparative effectiveness findings to improve health care quality, reduce unnecessary spending, identify best-in-class providers, and help employees make informed choices.

The Business Group's National Committee on Evidence-Based Benefit Design has been working since 2004 to translate research findings into recommendations for employer plan design, purchasing, and consumer engagement practices. With recent funding from AHRQ, a series of short Employer Guides were produced to help employers use comparative effectiveness in their health plans and programs. Each guide includes the following:

  • Evidence of the impact on employers;
  • A summary of the research findings;
  • Plan design, network selection, and/or employee engagement strategies for consideration; and
  • Links to AHRQ Consumer Summaries for employees.

As members of the National Business Group on Health, employers can contact the Business Group's public policy team with concerns by responding to public policy opportunities to comment on proposed regulations, contact Congress and/or the Administration, testify, or participate in related activities to advance CER.

Relevant Tools and Resources Include:

Page last updated: January 29, 2014

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