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Press Release Date: September 19, 1997
The Agency for Health Care Policy and Research (AHCPR)—the
federal research agency charged with finding ways to improve
health care delivery—and the American Association of Health
Plans' Foundation today announced a joint call for studies to
determine the impact of different features of health plans on the
quality of care provided to patients with chronic illnesses and
on outcomes. The foundation is the research arm of the American
Association of Health Plans (AAHP), a national organization
representing over 1,000 health plans that serve approximately 140
In making the announcement, AHCPR Administrator John M.
Eisenberg, M.D., M.B.A., said his agency and the foundation will
together provide up to $7 million over a three-year period to
support peer-reviewed, outcomes-focused studies.
"Research has moved beyond questions of differences between
managed and fee-for-service care or between types of health
maintenance organizations. We are now focusing on how changes in
organizational structures and care models being developed by
health plans impact patient health," said Dr. Eisenberg, who
added that the collaborative effort provides a framework for
impartial, scientifically rigorous studies.
Over 80 percent of privately insured Americans now depend on
some form of managed care for their health needs, as do roughly
30 percent of Medicaid recipients and nearly 14 percent of
Medicare beneficiaries. The two latter groups have the highest
incidence of chronic illnesses—the focus of this research.
"This joint, fast-track research effort will get the answers
we need; the next steps will be finding ways to address problems
and share and replicate successes," Dr. Eisenberg said. He added
that AHCPR will widely disseminate the results of the studies to
consumers, health plans, purchasers, health care practitioners
and policymakers, as well as the research community.
Karen Ignagni, M.B.A., AAHP's president, said, "This
research, which addresses quality and outcomes of care for people
with chronic diseases, will focus on special populations,
including women, minorities and the elderly, and will serve as a
catalyst to encourage cooperative research with others who have a
commitment to this mission." Ms. Ignani added that this
industry-wide research supplements the ongoing research of AAHP's
individual member plans and has the potential to greatly benefit
millions of Americans.
Although research to date has not been sufficiently
sensitive to variations in quality or outcomes that may result
from specific features of health plans, studies have uncovered a
number of challenges for both managed and fee-for-service plans.
These include the need for greater compliance with well-established guidelines for caring for patients with chronic
illnesses and the need to assess chronically ill patients'
understanding of their condition and examine their functional
The new research solicitation calls for studies focusing on
widespread chronic conditions or aggregations of conditions,
especially if they have a disproportionate impact on children,
women, minorities or the elderly. Health plan features that
researchers may want to study because they may affect performance
include the availability of specialists and subspecialists, types
of providers involved in primary care, and methods for
influencing provider practice, including risk-sharing.
After the approved proposals are funded, the principal
investigators will meet to develop some common questions and
coordinate approaches so that findings can be as broadly
applicable as possible to managed care organizations and/or
Applications must be
received no later than January 6, 1998.
For questions about the research, contact Dr. Bernard
Friedman, (301) 427-1674 (BFriedma@ahrq.gov), of
AHCPR's Center for Organization and Delivery Studies.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855
(KMigdail@ahrq.gov), Salina Prasad, (301) 427-1864
(SPrasad@ahrq.gov); or Susan Pisano, AAHP, at (202) 778-3245.