Weekend update

Congress returns to Washington this week. (In fact the Senate is in session now.)  June will be the last month of the Supreme Court's current term. There are five Mondays in June on which opinions can be delivered, including the important ACA related decision in King v. Burwell.

Last Thursday, the Bipartisan Policy Center issued a set of recommendations on preventive healthcare  decision making focused on incorporating cost efficacy and community health concerns therein.   Modern Healthcare reflects on those recommendations here (note -- the article's headline is out of synch with its substance).

Last Friday, the FEHBlog noted that HHS is seeking public comment on the HIPAA health plan identifier which is now in a state of limbo (not an unusual status for HIPAA standards). Here's a Health Data Management overview of that situation.  Here is recent provider testimony to HHS's National Committee of Vital and Health Statistics ("NCVHS") on the utility of a health plan ID.  What's puzzling to the FEHBlog given all of the Congressional buzz over adding interoperability to electronic medical records is why isn't HHS urging Congress to fund the adoption of a HIPAA patient ID. That certainly would aid interoperability.

The FEHBlog also found this update on CAQH CORE operating rules on the NCVHS website.  Congress as part of the ACA doubled down on HIPAA by incorporating into that law these privately developed rules intended to facilitate electronic claim transactionx. NCVHS is holding a two day hearing on the HIPAA standards and operating rules on June 16 and 17,

Just another weekday

May 29 is just another weekday for FEHBP carriers because the 2016 benefit and rate proposal must be submitted to OPM no later than this coming Sunday May 31 according to the call letter.

Time marches on though. The Wall Street Journal reports this afternoon that the board of directors of Humana, a major health insurer is considering selling the company to another health insurer such as Aetna or Cigna. Humana which is based in Louisville, KY, focuses on the Medicare market but also is an FEHBP carrier

The Ponemon Institute has released its 2015 study on the cost of data breaches. That's another cost curve that is headed up. "Over the past year, the cost of data breaches due to malicious or criminal attacks has increased from an average of $159 to $174 per record."

Today, the Department of Health and Human Services released a request for public comment on the future of the HIPAA health plan identifier. HHS pulled the rug out from under this initiative last year and with good reason for doing so. After all electronic claims have been processed for over 15 years without a health plan identifier. The comment deadline is July 28.

A couple months ago, the FEHBlog was doing backflips because the FDA had approved its first biosimilar drug Zarxio for marketing. Zarxio is biosimilar to a brand name cancer supportive drug Neupogen which Amgen manufactures. Yesterday the FEHBlog learned from Business Insurance that earlier this month the U.S. Court of Appeals for the Federal Circuit issued a preliminary injunction blocking the sale of the Zarxio pending an an Amgen appeal of a San Franciso federal district court decision rejected a Amgen patent challenge to Zarxio.  The Federal Circuit will hear oral argument on the appeal next Wednesday June 3. Lowering costs is not easy. But the FEHBlog remains confident that biosimilars will be on the U.S. market soon. After all, biosimilars have been offered in Europe for over a decade.

Midweek update

The FEHBlog cringes whenever he sees an email announcing a new set of Affordable Care Act FAQs.  He cringed yesterday when FAQ XXVII was issued. Part one of the FAQs was an effort by the regulators to circle the wagons around HHS. A few months ago, HHS released the 2016 notice of benefit and payment parameters, a massive annual rule making.  HHS explained in the preamble that health plans, beginning in 2016, must embed a self only out of pocket maximum in other than self and family coverage. Confusion reigned because HHS overlooked actually adding this requirement to the rules. Rather than amend the rule-making, HHS issued sub-regulatory guidance to cover its tail which climaxed in FAQ XXVII.  The ACA regulators collectively assert in FAQ XXVII that the embedded OOP maximum rule applies to all non-grandfathered plans, including group plans (e.g., FEHBP) and high deductible health plans. Cost curve up.

The other part of FAQ XXVII continues the saga of ACA FAQ XV which addressed in part the ACA's provider non-discrimination rule, PHSA § 2706. In response to Congressional complaints, no doubt spurred on by the chiropractor and other allied health professional lobbyists, the ACA regulators retracted the meat of the guidance of FAQ XV which of course favored health plans. The other shoe should drop before long with a new rule.  Cost curve up again.

The reason that the FEHBlog cringes upon the release of ACA FAQs is that the FAQs typically announce consumer protections that push the cost curve up just as we creep ever closer to 2018 when the high cost coverage excise tax kicks in as discussed in a recent post.  It's unfortuante that the ACA regulators can't simply let health plans offer consumers choice. In the FEHBP some plans offer embedded self only OOP maximums in self and family coverage. Others don't. If a consumer wants the embedded maximum, he or she can find it (via the summary of benefits and coverage or the plan brochure).

The Wall Street Journal reports that

[As] part of a growing push for so-called pay-for-performance deals amid complaints about the rising price of medications, some of which cost more than $100,000 per patient a year [, s]ome insurers and prescription-benefit managers are * * * arguing that they should pay less when drugs don’t work well in certain patients. Drug companies are countering with pricing models of their own, such as offering free doses during a trial period.

The FEHBlog does not quite follow this approach. If a much lower price is charged when the drug is ineffective, won't that encourage use of the drug on those cases?  In any event, Drug Channels reports on the drug trend reports of Express Scripts, CVS Health, Catamaran, and Prime Therapeutics. .

Happy Memorial Day

Retired Admiral Earl Gay, special advisor to the OPM Director, has posted some timely thoughts on opm.gov for this national holiday. Thank you for your service Admiral.

Congress is out of town this week. Here is a link to last week's activities from the Week in Congress.  The House Energy and Commerce Committee last week unanimously (51-0) approved the 21st Century Cures bill which would provide a funding boost to the National Institutes of Health and the Food and Drug Administration. There are a bunch of health care related pay-goes according to this Modern Healthcare article. Health Data Management reports that the bill also includes some strict electronic medical record interoperability mandates.

This New York Times piece on hospital productivity caught the FEHBlog's eye.  Enjoy the holiday.

TGIF

Ah yes, today is the end of the great three day holiday drought that runs from Presidents' Day to Memorial Day. The FEHBlog wishes everyone a great weekend.

Last Friday was the deadline for public comments on IRS Notice No. 2015-16 which was the first wave of guidance on the high cost coverage excise tax.  Beginning in 2018, the ACA imposes on 40% excise tax on the cost of employer sponsored coverage that exceeds $10,200 for self only coverage and $27,500 for self and family coverage.  The law includes permits an adjustment to those thresholds to the extent the cost of Blue Cross FEP Standard Option coverage over the period 2010-2018 exceeds 55%. That adjustment will wind being a big goose egg because according to the FEHBlog's calculations, Blue Cross FEP Standard Option coverage has increased only 18% over the period 2010 through 2015. In any event, the FEHBlog suggest that readers take a gander at the American Health Insurance Plans' comments to the IRS. AHIP makes many good points. In short this is a very disruptive tax which merits repeal.

Modern Healthcare offers an interesting story about the coverage conflicts between insurers on one side and doctors and patients on the other caused by the price of the very expensive Hepatitis C drugs. The most sensible solution is for Gilead Sciences to lower the absurdly high price (even after discounts), but that's unlikely to occur.

Healthcare Dive reports on the indictment of a Texas anestheisologist who allegedly defrauded our beloved FEHB Program to the tune of $5 million.

The New York Times reports on CVS's acquisition of Omnicare this week and its writer predicts that this acquisition signals the end of pharmacy mergers due to market concentration.  Omnicare's principal business is distributing medications to nursing homes and other institutions, which is an obvious fit with CVS's business. The article adds, however, that

One of Omnicare’s main moneymakers is expensive niche medicines, which it helps manufacturers distribute and get reimbursed for by insurers and the United States government. Those drugs account for about a quarter of company sales, and those sales are growing at an annual rate of more than 20 percent. But the lucrative business may end up conflicting with Caremark’s focus on extracting discounts from pharmaceutical firms.

It will be interesting to see how the Justice Department and the Federal Trade Commission react.

Subrogation, Surveys, and even more

Today, the U.S. Office of Personnel Management published a final rule to help FEHB plan carriers in their ongoing efforts to recover benefits from other responsible parties and insurers.  For example, if an FEHB plan member is injured in a motor vehicle accident, the FEHB plan will cover the costs of treating the injury and then will pursue the motor vehicle insurers to recover the payments.  It's equitable. The rule makes it clear that the FEHB Act overrides state laws that may interfere with this process.

Two recent note-worthy surveys:

• U.S. News and World Report has released a nationwide survey of the quality of hospital delivery of five common services.  
• Fierce Health Payer reports on two surveys of healthcare provider attitudes toward health insurers / their golden geese. 

Modern Healthcare reports on Carefirst's report of a large and sophisticated cybersecurity breach.  Experts quoted in the article blame the insurer for keeping massive volumes of data data too long. The FEHBlog certainly recognizes the benefits of data minimization. However, laws require health insurers to collect massive amounts of data. Most recently, the IRS has required insurers to collect millions of family member Social Security Numbers in order to document their compliance with the ACA's individual shared responsibility mandate (IRS Form 1095-B). What's more, ERISA and OPM's FEHBP rules include a six year record retention period. Looming over these requirements is the federal False Claims Act's 10 year record retention requirement. The law does not permit data minimization.  

The Justice Department recently issued guidance on best cybersecurity practices.  Health Data Management offers ten steps to protect health data.  It's a hot issue indeed. 

Tuesday Tidbits

Well we are less than two weeks away from the deadline imposed on FEHB plan carriers for submitting their 2016 benefit and rate proposals to OPM. It's a busy time for carriers.

Fierce Health Finance reports that "The latest price data from the Altarum Institute indicate hospital prices rose 0.4 percent in March compared to March 2014, an increase Altarum referred to as "scant." For the entire healthcare sector, prices rose 1.3 percent year-over-year."  Over the same period, the CPI-U for all items declined by 0.1%.  So that's a significant jump in healthcare.

Drug Channels reports that the drug store industry is maintaining a steady profit margin.

In an bit of good news, Health Day reports that due to the work of U.S. Preventive Services Task Force fewer men are undergoing the PSA screening test for prostate cancer. The USPSTF has concluded that the test creates more problems than it solves and doctors are accepting this recommendation.

Healthcare Finance reports that the incoming AMA President Steven Stack has not thrown in the towel on his effort to kill the ICD-10 coding system which is scheduled to take effect October 1. Health Data Management reports on a bill to expand ICD-10 testing and create an 18 month transition period (HR 2247).  CMS is planning on a clean break. We shall see.

Weekend update

The FEHBlog spent his weekend driving up to New Haven, Connecticut, and back. The principal purpose of the trip was a visit a close friend who is hospitalized at Yale New Haven.  Consequently the FEHBlog has not had much time to think about this weekend update, but the trip was worthwhile.

Congress was in session last week as explicated in The Week in Congress.  Congress will continue in session this week and return to their home districts for the week following Memorial Day.

The House is working on the FY 2016 defense authorization bill which usually has government contracting implications for FEHB contractors and a 21st Century Cures Act which is aimed at the Food and Drug Administration. Here's a link to a Health Affairs blog article on that important bill.  Health Data Management reports that the latest version of this bill also includes a rather strict electronic medical records interoperability mandate.

Studies, studies, studies

Prescription benefit manager Express Scripts issued a report titled, Super Spending: U.S. Trends in High-Cost Medication Use.  The report

examines prescription drug use among patients with exceedingly high annual medication costs under the pharmacy benefit. The number of U.S. patients estimated to have annual medication costs greater than $50,000 jumped 63 percent between 2013 and 2014, from 352,000 to 576,000 Americans. The population of patients estimated to be taking at least $100,000 worth of medication nearly tripled in the same time period, from 47,000 to 139,000 Americans.

And of course, the drugs at issue are specialty drugs and insurers covered virtually all of the costs.  This is a trend that needs to be curbed quickly as the ACA's high cost coverage excise tax kicks in about 30 months from now (2018).  Express Scripts offers some strategies and tactics.

OPM and the rest of the federal government has been promoting cessation of tobacco use. The other major PBM CVS Health reported on a tobacco cessation study conducted on 2500 of their own employees.

The researchers randomly assigned approximately 2,500 CVS Health colleagues and their family and friends to one of four incentive-based smoking cessation programs or to usual care, which consisted of informational resources and free access to a behavioral-modification program and nicotine-replacement therapy. Across all of the incentive-based programs, participants were eligible for up to $800 for successfully quitting smoking but the programs differed in how incentives were accrued and disbursed. Two of the programs required participants to pay an upfront deposit of $150, which was reimbursed if participants successfully quit smoking.  Overall, study participants who enrolled in any of the four incentive-based programs were nearly three times more likely to quit smoking than those who received usual care alone. In addition, although participants assigned to the groups requiring an upfront deposit were more likely to decline participation than those in the pure incentive-based programs, deposit programs led to nearly twice the rate of abstinence from smoking at six months among people who would have accepted either type of program.

The study appears to confirm human nature. OPM, however, does not allow FEHB carriers this level of flexibility in crafting their smoking cessation programs.

The Health Care Cost Institute which is a consortium of health insurers released a report on the cost of diabetes care in the U.S.

The report, Per Capita Health Care Spending on Diabetes: 2009-2013, is one of the first of its kind to examine health care spending for adults and children with diabetes relative to those without diabetes, both in terms of total per capita health care spending and out-of-pocket costs. It is based on the health care claims of more than 40 million Americans younger than 65 covered by ESI from 2009 to 2013. HCCI identified 5.3% of the ESI population as having diagnosed diabetes (type 1 or type 2) in 2013, up from 4.7% in 2009.
“The number of people with diabetes continues to grow, as does the health care spending for these individuals,” said HCCI Executive Director David Newman. “We, and others, need to better understand the relationship between spending and actual health outcomes for people with diabetes, particularly children.” 

Good luck with that effort. HCCI does good work.

FAQ Follow-up

The NPR / Kaiser Health News report on Monday's ACA FAQ XXVI says it all.  

Free means free. The Obama administration said Monday that health plans must offer at least one option for every type of prescription birth control free of charge to consumers. The instructions clarify the Affordable Care Act's contraceptive mandate. 

If you want the backstory, read Robert Pear's April 29 article in the New York Times "Insurers Flour Rules Covering Birth Control, Studies Find."  However, it's clear at least to the FEHBlog that the ACA regulators did not believe that insurers were flouting any rules because the agencies applied the new mandates to the next plan year, not immediately.   ACA FAQ XXVI illustrates the fact that the ACA turned health insurers, including FEHB plans, into public utilities. Whether that's good or bad is for readers to judge.

ACA FAQ XXVI also mandates that free colonoscopies must include free anesthesia.  The FEHBlog, as an older gentleman, applauds that mandate. Yesterday the Washington Post reported that endoscopy centers are beginning to use a machine to perform anesthesia at colonoscopies.   The machine called Sedasys is manufactured by Johnson & Johnson and is FDA approved over the objections of, of course, anesthesiologists.  (As a guild member, the FEHBlog cannot possibly sneer at another profession for attempting to protect their turf.)   The machine, which of course is monitored by nurses, works and here's the rub --

Sedation can cost even more than the colonoscopy, with anesthesiology fees adding up to $2,000. By contrast, Sedasys costs $150 to $200 each time.

If a drug manufacturer such as Gilead Sciences had been pricing Sedasys, the price would have been $2,000 each time or maybe $1995.

FAQs

The ACA regulators issued ACA FAQ XXVI) today.  These FAQs, which respond to consumer group complaints, address various aspects of the ACA mandate on non-grandfathered plans (most FEHB plans) to cover certain preventive services with no enrollee cost sharing when provided in network. 

CCIIO also issued FAQs on the new HHS mandate to embed an individual self only out of pocket maximums under other than self only enrollments. As indicated in the FAQs, HHS announced this mandate in the preamble to the 2016 notice of benefit and payment parameters but as unmentioned in the FAQs, HHS failed to appropriately amend the ACA rules. This oversight doesn't seem to concern CCIIO. The FEHBlog is surprised that HHS has not issued an errata to the notice of benefit and payment parameters. That fix may be still be forthcoming.

Weekend update

Happy Mothers' Day to all.

Congress continues in session this week. The FEHBlog keeps waiting for the Financial Services Subcommittees of the House and Senate Appropriations Committees to consider OPM's proposed budget. Nothing has popped up on their calendars yet.

OPM has submitted a final FEHBP rule to the U.S. Office of Management and Budget for its approval:

AGENCY: OPM RIN: 3206-AN14
TITLE: Federal Employees Health Benefits Program; Subrogation and Reimbursement Recovery
** RECEIVED DATE: 05/07/2015 LEGAL DEADLINE: None

There are several other FEHBP rules that are in the finalization process, e.g., self plus one enrollment type, new plan performance assessment system.  The FEHBlog appreciates reginfo.gov.

On Friday, the U.S. Attorney in Jacksonville, Florida, announced that "the United States has settled allegations that nine hospitals in Jacksonville had a practice of routinely ordering basic life support ambulances when this type of transport was not medically necessary. The United States has also settled allegations with an ambulance company for its role in submitting millions of dollars of false claims to federal healthcare programs."  The false claims totaling millions of dollars
affected the FEHBP as well as other federal health care programs.

TGIF

It's the 70th anniverary of the Allies victory over Nazi Germany in World War II. Around noontime, the FEHBlog watched a World War II warplane flyover on the National Mall here in Washington, D.C.  Cool.

Here's a link to the Week in Congress. The Senate joined the House of Represenatives this week in passing an FY 2016 budget resolution that includes reconciliation provisions to repeal the ACA. Timothy Jost reviews the ACA aspects of the budget resolution here.

Health Data Management reports on the latest Ponemon Institute study on health care related data breaches.

For the first time, criminal attacks are the leading cause of data breaches in healthcare, with such attacks up 125 percent versus five years ago, replacing lost laptops as the top cybersecurity threat to the industry. That is the finding of a new study by the Ponemon Institute, sponsored by security software and services vendor ID Experts, in which 45 percent of healthcare organizations indicate the root cause of their data breach was a criminal attack and 12 percent say it was due to a malicious insider.

Wow. The lost laptop problem was resolved by encryption. Hopefully it won't be long before operating system data can be encrypted without disrupting operations.

Employee Benefit News reports on the growing patient and payer comfort level with telehealth services.

The U.S. telemedicine market is expected to reach $4.5 billion by 2018 – a massive gain from $440.6 million in 2013, notes a recent study by business information provider HIS. In addition, a recent Harris Poll found that 64% of the 2,019 U.S. adults it surveyed are willing to have doctor visits via video telehealth.
Employers are now warming up to the concept, which could save them more than $6 billion a year in health care costs, according to Towers Watson analysis. The consulting firm also found that 37% of U.S. employers with at least 1,000 employees expect to offer telemedicine consultations by 2015 compared with 22% in 2014 and another 34% are considering it for 2016 or 2017.

Drug Channels reports based on 2014 sales data that Walgreens and CVS sit on top of the pharmacy chain mountain.

Kaiser Health News reports based on a Harvard study that hospital closures generally do not adversely affect community health care.

Tuesday Tidbits

• Govexec.com reports that Rep. Steven Lynch has introduced a bill in Congress (H.R. 2715)  that "would prohibit [FEHBP prescription benefit managers] PBMs from switching drugs without a physician’s approval; demand PBMs return to the federal plan 99 percent of all rebates, market share incentives and other monies from pharmaceutical companies in exchange for FEHBP business; and create stronger disclosure requirements." The National Treasury Employees Union came out in strong support of the bill.  NEWS FLASH:  The Office of Personnel Management introduced these reforms by contract five years ago as first explained in Carrier Letter No. 2010-04.  In contrast to Medicare, reforms can be implemented and revised contractually which is much more flexible than passing a law. 
• In their press release, the NTEU states "FEHBP cannot buy drugs off the Federal Supply Schedule, which is why the program’s prescription costs are 15 percent to 45 percent higher than those for Medicare and federal health care systems run by the Veterans Administration and the Pentagon, the NTEU leader said." Be careful what you wish for.  There are two components to cost -- price and volume. In order to take advantage of statutorily low prices, the government must restrict the drug formulary to those low priced drugs.  In any event, the FEHBP already has high generic drug utilization in the FEHBP -- a big cost saver -- and the federal supply schedule focuses on drugs that are still under patent. 
• This brings me to my final point related to this bill. The FEHBlog often reads that prescription drug spending is 30% or so of the FEHBP's benefit spend. That is  ten to fifteen percentage points higher than the commercial sector.  The reason for the 30% figure is that the FEHBP has a boatload of annuitants with Medicare Part A hospitalization coverage. Medicare covers the hospital bills for these annuitants, and the FEHBP covers their prescription drug costs. The FEHBlog expects that absent Medicare, FEHBP's spending on prescription drugs would be in line with other commercial carriers.
• Yesterday, according to Accounting Today, the IRS released the 2016 dollar adjustments to limits on contributions to health savings accounts,  the minimum deductibles for high deductible health plans, and the upper limit on out-of-pocket cost maximums for those plans IRS Rev. Proc 2015-30).
• The FEHBlog also noticed an interesting FierceHealthPayer article about a New Jersey health insurer QANI now part of Cigna that stratified its membership by high, moderate, and low utilizers / risks and then focused appropriate managed care attention on each segment. The attention relied on technology and member engagement.  "The engagement program has succeeded to the point that, as of 2015, QANI applies it across its membership base."

Weekend update

The FEHBlog is visiting lovely Denver Colorado. Meanwhile back in Washington, DC, Congress is in session this coming week. Here is a link to the Week in Congress's review of last week's activities.

This is also Public Employee Recognition Week.  Thank you government and postal employees.

At the OPM FEHBP Carrier conference in late March, OPM read off a laundry list of FEHBP regulations that the agency is in the process of finalizing. While none of those regulations have been submitted to the U.S. Office of Management and Budget for final approval as yet, reginfo.gov does tell us that an important HHS proposed rule is now pending at OMB:

AGENCY: HHS-OCR RIN: 0945-AA02
TITLE: Nondiscrimination Under the Patient Protection and Affordable Care Act
STAGE: Proposed Rule ECONOMICALLY SIGNIFICANT: Yes
RECEIVED DATE: 04/29/2015 LEGAL DEADLINE: None

This is the rule that will explain HHS's approach to a complicated ACA provision, Public Health Service Act Section 1557.   

Recently, according to the Miami Herald, CIGNA was sued under this provision claiming that "the insurer forces HIV patients to obtain their medications solely through mail-order.  The suit, filed by nonprofit consumer group Consumer Watchdog, national litigation and healthcare group Whatley Kallas, LLP, and Miami-based class action law firm Podhurst Orseck P.A., claims that Cigna’s mail-order-only policy risks the health and privacy of its patients.  Lack of choice, the lawsuit claims, equates to discrimination."  Of course, CIGNA was requiring all of its members under certain circumstances to use its mail order pharmacy. This is a standard plan design practice that helps control premiums. Hopefully, the HHS rule will sanction standard non-discriminatory benefit design practices. The FEHBlog is keeping a close eye on this rule. 

Employee Benefit News reports that last Thursday United Healthcare announced a partnership with three telehealth companies, Doctor On Demand, Optum’s NowClinic and American Well – to cover visits with a doctor via video technology, just as it would for in-person visits.  Good idea. 

May Day

Ah, it's the first of May.  The beginning of the three best months of the year (weather-wise) here in Washington, DC.

Two other insurers, Cigna and Humana as well as the two big prescription benefit managers, CVS Health and Express Scripts, have reported their first quarter results. The winter weather did not adversely impact healthcare companies.

The Federal Times reports that the reconciled FY 2016 budget moving through Congress does not include any express federal employee benefit cuts. However, the resolution does direct the Congressional committees to reduce civil service spending which in turn could lead to reductions. Specifically, according to the Washington Post, "The joint budget agreement calls for cutting that amount over 10 years from programs under the House Oversight and Government Reform Committee," which of course has jurisdiction over the FEHBP and other federal employee benefit programs. .Defense spending would be increased.

Yesterday, CMS released details on $103 billion of Medicare spending on prescription drugs in 2013. The Administration trumpets this action as evidence of its transparency and the action certainly has attracted press attention as illustrated by this Kaiser Health New collection of articles. However, the FEHBlog thinks that OPM's "small ball" request made in the 2016 call letter that FEHBP carriers offer a webtool that allows consumers and their healthcare providers to see consumers would pay for prescription drugs pushes the transparency ball down the path further than this HHS move.

Health insurers and employers have been funding a Patient Centered Outcomes Research Institute ("PCORI") to the tune of millions of dollars since the ACA's enactment. The FEHBlog has wondered what the PCORI has accomplished other than spending the money on research studies. The FEHBlog is gratified that Modern Healthcare is asking the same question.

The Affordable Care Act created an independent organization to support research that assesses which healthcare interventions are most effective. But three years after it started funding studies, there's no central repository of results or a clear strategy for making sure the knowledge reaches the clinicians it's intended to influence.
The Patient-Centered Outcomes Research Institute distributed grants worth $30 million to its inaugural round of 50 projects. About 30 are complete and more results are anticipated this summer, PCORI leaders told Modern Healthcare.
It's not clear, however, when or where those results can be found. PCORI says grantees are expected to have a plan for sharing their findings but also that it does not set timelines for completing studies.
As of last week the group said it had not been notified by project leaders of the completed research whether or not they have submitted manuscripts to peer-reviewed journals. The institute also said it does not have a central database where results can be shared, and researchers are not required to submit manuscripts to journals for publication. 

This problem could have a quicker fix than the electronic medical record interoperability problem. Time will tell.