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Health Insurer Use of Comparative Effectiveness Research for Innovation in Health Care Re-Design

*Daryl Wansink, Blue Cross Blue Shield of North Carolina 

Keywords: quasi-experimental design, administrative claims data, propensity score matching, health care re-design

The urgent need to contain rising health care costs has insurers turning to CER more than ever. New models of health care delivery, insurance benefit design and health care provider reimbursement are needed to resolve the crisis. The lack of published evidence for solutions and the timing to deliver the solutions requires insurers to explore data they have at hand. Several examples of quasi-experimental research using administrative claims data and public databases will be reviewed to show the role of CER in corporate decisions related to patient centered medical homes and value-based insurance design.