The ACC has signed on to support a Consumers Union consensus statement that urges the Senate to retain the Patient-Centered Outcomes/Comparative Effectiveness Research (CER) provisions in health care reform. The good news is how broad and basic it is — amazingly, they got good support from health plans on this.

Both chambers of Congress have different view on CER, including whether to follow the "Federal Reserve" model, in which the research is relatively independent of government, or the government approach, housing the research center within AHRQ. Who will sit on the review board is a bit of an issue, too, but both chambers are looking at a good cross-section of the whole health care community, including government, industry, patients, physicians, researchers and similar stakeholders. 

One of the big fears out there — which it seems is being addressed very carefully in all the legislation I've seen (but that doesn't stop naysayers from hyperventilating about it) — is that the government will use CER as a basis for cost-containment and restrictive coverage decisions. Critics are using the recent mammography guidance as an example of rationing through CER. To be clear, the ACC and Consumers Union wholeheartedly support CER that separates cost efficiency from clinical effectiveness.

Our ACC Medical Directors Institute this year focused completely on CER, and we'll continue to delve more deeply into some topics, such as shared decision-making with patients/providers and helping IOM and the Federal Coordinating Council for CER in action plans related to their research priorities.  It will be interesting to watch this unfold!

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