Health Plan Research Networks

A key factor in realizing PCORnet’s full potential to drive meaningful, patient-centered research is access to complete, longitudinal data on populations receiving health care within PCORnet Partner Networks, including both Clinical Data Research Networks (CDRNs) and Patient Powered Research Networks (PPRNs).  CDRNs are continuously capturing electronic health record (EHR) data from both ambulatory and in-patient care, as well as claims information or other records representing care received outside participating delivery systems. However, to reduce gaps in existing data, PCORI has embarked on a supplemental approach: an initiative to directly fund two major U.S. health plans that cover significant numbers of patients in one or more of the PCORnet CDRNs.

These health plans form the Health Plan Research Networks (HPRNs) and partner with PCORnet CDRNs and PPRNs, engaging in data linkage governance and technical activities in a comprehensive, stepwise approach toward successful linkages of claims and EHR data for use in conducting comparative clinical effectiveness research (CER). The two initial health plans awarded in 2016 are:

HealthCore-Anthem Research Network
HUMnet: Humana

Year one of the initiative will focus on data linkage to support the research aims of PCORnet’s Demonstration Studies, and years two and three will focus on helping to craft appropriate governance alongside linkages with CDRNs and PPRNs for additional research projects and the development of multipurpose linked data sets.

By bringing health plans into the conversations around research focus, PCORI and PCORnet are trailblazing a new frontier of patient-centered care and enabling quicker patient treatment decisions based on the output of CER studies. As health plans are often closely connected to outcomes research, the path to supporting reimbursement for the favorable treatment path is simplified. Thus, collaboration between researchers and health plans can inform the direction of research to increase the likelihood of improving health care for patients.

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Last updated on August 24, 2017