Blue Cross and Blue Shield Association Proposes Payer-Funded Institute to Evaluate What Medical Treatments Work Best

Blue Cross and Blue Shield Companies Would Provide Financial Support

May 07, 2007, 01:00 ET from Blue Cross and Blue Shield Association

    WASHINGTON, May 7 /PRNewswire-USNewswire/ -- The Blue Cross and Blue
 Shield Association (BCBSA) today called upon Congress to enact legislation
 to establish a new, independent institute -- funded by all healthcare
 payers -- to provide consumers and providers with much needed information
 on which medical treatments work best. This proposal is an important
 component of a multi-pronged strategy BCBSA will be announcing in the
 coming months to improve healthcare value and quality for consumers.
     It is estimated that up to 30 percent of healthcare spending pays for
 ineffective, inappropriate or redundant care. As policymakers debate how
 best to reform our healthcare system, BCBSA believes it is critical to
 start by developing the knowledge base to empower patients and providers
 with credible information to ensure the delivery of appropriate and timely
     Under BCBSA's proposal, the institute would support research comparing
 the effectiveness of new and existing medical procedures, drugs, devices,
 and biologics.
     The institute would support a broad range of research, including much-
 needed clinical trials, and be governed by a board representing
 stakeholders in the government and private sector.
     The most significant barrier to creating a new institute is
 establishing a significant and stable funding source. BCBSA proposes
 funding the institute by assessing all private (insured and self-funded)
 and public healthcare coverage such as Medicare, Medicaid, and other
 government programs. BCBSA, as a leading provider of healthcare coverage to
 more than 98 million people, is prepared to contribute substantial
 financial support to the initiative.
     "Credible information on what treatment works best holds the most
 promise for improving the value and quality of our system," said Scott P.
 Serota, BCBSA president and CEO. "Today, patients often are paying for
 sub-optimal care. This institute is an important step to assuring that we
 are providing the best incentives to deliver the best care."
     To ensure the new research improves clinical practice, significant
 education and incentives will be needed. BCBSA recommends that the new
 comparative information be quickly and efficiently disseminated to
 providers, patients, and others, and that the research results be
 incorporated into clinical practice guidelines through close collaboration
 with medical societies.
     "New research on the effectiveness of different treatments offers
 promise in addressing many significant issues including access to care and
 affordable coverage, improving healthcare quality and safety, and
 increasing transparency and accountability," said Debra Ness, president of
 the National Partnership for Women & Families. "I'm pleased that the
 institute will translate its research into language that consumers can
 understand. Consumers need this kind of information so that together with
 their providers, they can make more informed decisions about their
     Another important element of the proposal calls for physicians who rely
 on practice guidelines established through the institute's research to be
 given safe harbor for non-economic and punitive damages when faced with
 claims of medical malpractice.
     "The institute would close critical gaps in our medical understanding
 of the efficacy of certain treatments and, in the end, improve the quality
 of care for America," said Dr. John Fallon, chief physician executive, Blue
 Cross Blue Shield of Massachusetts. "Collaboration among key stakeholders,
 including providers and consumers, will be essential to the success of this
     A summary of the proposal and more information can be found online at
     The Blue Cross and Blue Shield Association is made up of 39
 independent, locally operated Blue Cross and Blue Shield companies that
 collectively provide healthcare coverage for more than 98 million -- nearly
 one-in-three -- Americans. For more information on the Blue Cross and Blue
 Shield Association and its member companies, please visit
                              Quotes in Support of
                       Comparative Effectiveness Research
     "Comparative clinical effectiveness research is crucial to moving
 toward a high quality, high value health care system. Doctors and patients
 need more credible evidence of what works best when they make treatment
 decisions. I believe more investment in this research in the U.S. will help
 curb the growth in costs across the health care system by giving doctors
 and patients information they need to choose the right care at the right
 time. Congress should move this year on this important issue. I welcome
 ideas, like the proposal put forth by the Blue Cross and Blue Shield
 Association, to move this valuable research forward."
     U.S. Senator Max Baucus (D-MT)
     "I applaud the Blue Cross and Blue Shield Association for their
 leadership in promoting the creation of a comparative effectiveness
 institute. This initiative will go a long way to address the rising cost of
 healthcare and benefit consumers with increased patient safety and quality
     U.S. Senator Kent Conrad (D-ND)
     "Researching the most effective treatments, drugs and devices will
 improve patient outcomes and could help lead to lower healthcare costs. The
 new comparative effectiveness institute proposed by the Blue Cross and Blue
 Shield Association will fill this critical knowledge gap and promote higher
 quality and more cost-effective treatments for all Americans."
     Newt Gingrich, founder, Center for Health Transformation and former
 Speaker of the House

SOURCE Blue Cross and Blue Shield Association