The work of groups established by the healthcare reform law to explore better ways of delivering and paying for healthcare will continue as planned now that President Barack Obama secured a second term, but experts say looming deficit talks could jeopardize some of their funding.
Uncertainty has lingered even as groups like the Patient-Centered Outcomes Research Institute have made progress over the past two years, unveiling new projects and doling out grants.
PCORI, a Washington-based independent not-for-profit charged with supporting comparative effectiveness research, has named senior leaders, announced research priorities and awarded millions in funding since its inception. In June, for instance, the group announced it would give out 50 awards, totaling $30 million, as part of its Pilot Projects Program.
The Center for Medicare and Medicaid Innovation, meanwhile, has awarded a slew of grants for projects focused on readmissions, medical homes, sepsis, shared decision-making and other areas. The CMMI is set to receive more than $10 billion over the next 10 years.
“I wouldn't be surprised if some of the money for these programs is cut a little to reach a deficit deal, but the program elements will not go away,” said Dr. Robert Wachter, professor and chief of the division of hospital medicine at the University of California, San Francisco.
Ann Bonham, chief scientific officer of the Association of American Medical Colleges, said she expects both PCORI's funding and mission to stay intact given the results of the presidential election. “I'm actually not worried at all now,” she said. “There is fairly strong bipartisan support of comparative effectiveness research.”
Despite that support, both PCORI and the CMMI have been subject to attacks in the past. In July, a House Appropriations Subcommittee voted to defund several groups associated with the healthcare reform law, including the CMMI, PCORI and the Prevention and Public Health Fund. The panel also voted to defund HHS' Agency for Healthcare Research and Quality.
Stuart Guterman, vice president of the Commonwealth Fund and executive director of its Commission on a High Performance Health System, said he hoped there wouldn't be a repeat of such strategies in the future. “If you think there are ways to improve the ACA, work with folks who are trying to implement it, but don't stand in their way.”