Highlights of the Session on the Role of Payers in the Clinical Research Enterprise

What do payers need from the Clinical Research Enterprise?

  • Payers depend on the Clinical Research Enterprise to develop the interventions that will improve the health of the populations they serve and society as a whole. Payers need to understand what works and what does not work in the care of patients, the prevention of disease, and the promotion of health. They need to know how to provide safer care and eliminate errors to keep members free from harm while participating in health care.

  • Payers need new knowledge on how to transform health care into a more systematic effort and how to help professionals understand that they are part of this systematic effort. They need to give guidance on how to transform the culture of medical practice from a profession-centered, individual activity into a patient-centered, team activity. They need more insight into population-based community methods of improving individual and community health.

  • Payers need to know from the enterprise which research projects are of high quality and which are not, and which research efforts are safe and which are not. They need to know which researchers have conflicts of interest and what those conflicts are. They need full disclosure of information regarding research funding to the public, potential research participants, and other stakeholders.

  • Research is needed on the barriers to the delivery of or patient adherence to interventions or behavior change, such as health illiteracy, cultural competencies, insurance issues, financial issues, or transportation issues.

How has the Clinical Research Enterprise met payers’ needs?

  • The Clinical Research Enterprise provides the knowledge that helps payers understand that what they do for patients is helpful. It provides payers with innovations that improve care, prevent illness, and promote health. The Clinical Research Enterprise holds the potential to question existing practice and help over time to eliminate ineffective and even harmful practices.

What are payers willing to contribute to the Clinical Research Enterprise?

  • Payers play a role in encouraging dissemination of medical technologies of proven safety and effectiveness. They can also encourage the implementation of evidence-based guidelines and consensus statements in clinical practice.

  • Payers have supported research activities both independently and by forming partnerships with medical institutions, medical societies, employers, federal agencies, private foundations, pharmaceutical companies, and medical professional organizations.

  • Payers help put clinical research findings into practice through disease management efforts and provider-education initiatives. They also disseminate health information to their members through health education programs.

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