Notable payer feedback includes: Based on the payer feedback, the paper also offers some strategies for engaging payers, including: The release of this white paper comes at a time of intensifying commitment within AHRQ and PCORI to ensure its research results are “useful” to decision makers. AHRQ’s Director has indicated that ensuring AHRQ’s research is used is a top priority. In recent months, PCORI created an evaluation task force to measure the effectiveness of its work and proposed criteria to help PCORI identify studies that could yield useful information. In their quest to support the generation of useful research, AHRQ and PCORI are likely to expand beyond its traditional stakeholders (clinicians and patients) to consider and measure how research is used by other decision makers. This will lead to a new crop of CER questions that will more directly align with the information needs of payers, clinical guideline organizations and developers of decision support tools.
- They do not consistently use EHC reports as a source of evidence for decision making.
- They would like to engage with AHRQ, especially in topic development and refinement and in the identification of future research needs.
- They would like reviews to include information regarding resource utilization and cost, quality of life, and certain subpopulations. They also generally support the inclusion of observational studies in comparative effectiveness reviews.
- They view lack of clear recommendations as a hurdle to using EHC reports.
- Targeting outreach to payer groups for input on Key Questions during the public comment period.
- Presenting a summary of findings to payers during the peer review phase and soliciting input on the information that would be most useful to them.
- Maintaining focus on in-depth reviews rather than quick turnaround reports to continue to fulfill the need for methodologically rigorous research, used to defend coverage policies.
AHRQ is likely to operationalize some of the recommendations in the paper to increase engagement with payers. Steps in the near term might include soliciting targeted input from payers on Key Questions for comparative effectiveness reviews and, for reviews already completed, gaining feedback on the best way to present research findings.
To read AHRQ’s new White Paper, click here.