"I thought they would go the route of the Institute of Medicine...which was very specific down to the actual research."
But when she read the report, she began to see a different picture, she explains. "They're trying to carve a different niche for themselves, and that may be where we have to start, is to begin asking people ... how to actually integrate the end users of the information into the actual research infrastructure.
More specific areas will likely come later, Carino says, when the payer community, instead of just federal appropriations, starts to pay PCORI's bills.
The institute is budgeted to spend $4.51 billion between 2010 and 2019. But starting in fiscal year 2013, in addition to $150 million per year from general appropriations, PCORI's funding will come from a $1 annual per member charge to health plans with another $1 per Medicare beneficiary coming from the Medicare Trust Fund. Funding goes up for health plan members and Medicare beneficiaries to $2 for each starting in 2014.
The five broad areas the institute listed are:
1. Comparative Assessment of Options for Prevention, Diagnosis, and Treatment
This includes studies that compare effectiveness of strategies for prevention treatment, screening, diagnosis or surveillance that have not been adequately studied against alternative options to better support decision-making and studies that compare risk-stratification and prognostication tools with attention to demographic, biological, clinical, social, economic and geographic factors that influence outcomes.