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Blues Urge Comparative Effectiveness Panel

By Mary Agnes Carey, CQ HealthBeat Associate Editor

May 7, 2007 -- The Blue Cross and Blue Shield Association Monday urged Congress to pass legislation to create an independent, public–private partnership to compare the effectiveness of medical treatments and technologies.

Up to 30 percent of health care spending is ineffective, inappropriate, or redundant care, Blue Cross and Blue Shield President and Chief Executive Officer Scott P. Serota said at a news conference. Finding which treatments work best would be "a major step forward for all of us in the health care arena," that could help cut costs and improve the quality of care, Serota said. The Agency for Healthcare Research and Quality within the Department of Health and Human Services currently conducts such research.

America's Health Insurance Plans, a trade group representing insurers, announced a similar public–private entity last month.

Under the Blue Cross plan, private insurers and federal government health care programs, including Medicare and Medicaid, would fund the entity, which would require approximately $500 million annually, Blue Cross estimates. The entity would support a broad range of research, especially clinical trials.

Physicians who relied on practice guidelines established through the entity's research would be given safe harbor for non-economic and punitive damages when faced with medical malpractice claims. Since 1995, the House has passed legislation eight times that would limit non-economic damage awards in medical malpractice suits to $250,000, but those measures have gained little traction in the Senate.

"I know this is a politically heavy lift but I think this is the right point to start the conversation," said John Fallon, senior vice president and chief physician executive of Blue Cross Blue Shield of Massachusetts.

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