Translating comparative effectiveness research into Medicaid payment policy: views from medical and pharmacy directors

J Comp Eff Res. 2015 Mar;4(2):79-88. doi: 10.2217/cer.14.68.

Abstract

Background: As the USA seeks to expand the conduct and dissemination of comparative effectiveness research (CER), views of key stakeholders will help guide the way.

Methods: We surveyed 60 medical and pharmacy directors from 46 state Medicaid programs.

Results: Over 90% felt that CER would lead to better clinical decision-making and overall value within 5 years and were willing to consider cost-effectiveness in setting medical policy. However, perceived poor quality, inconclusive research, restrictive legislative mandates, lack of budget impact and coverage recommendations, and lack of an independent body to interpret study results were major barriers cited to using CER evidence.

Conclusion: Given the significant resources being invested in CER, it is critical that these barriers are overcome to maximize its usefulness for stakeholders.

Keywords: CER; Medicaid; PCOR; PCORI; barriers; comparative effectiveness research; decision-making; evidence; medical policy; patient-centered outcomes research; recommendations; usefulness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Comparative Effectiveness Research / methods*
  • Comparative Effectiveness Research / standards
  • Cost-Benefit Analysis
  • Decision Making*
  • Health Expenditures*
  • Health Policy / economics*
  • Humans
  • Medicaid / economics*
  • Surveys and Questionnaires
  • United States