Centers of Excellence to Study High-Performing Health Care Systems

AHRQ has funded three Centers of Excellence that will identify, classify, track, and compare health care delivery systems to understand the organizational and environmental factors affecting the use of evidence-based medicine.

The Centers of Excellence to Study High-Performing Health Systems will:

Identify characteristics of health systems that successfully disseminate and apply evidence from patient-centered outcomes research (PCOR).
Analyze the connections between successful dissemination of PCOR, patient health outcomes, and effective use of resources.

Understanding how health systems disseminate information on what works and what does not work will facilitate successful dissemination of evidence-based practices moving forward. The three grants, which began in September 2015, will provide approximately $52 million over 5 years to study how complex delivery systems disseminate evidence-based findings and provide lessons learned to inform the dissemination of findings in other settings.

This project is funded by the Patient-Centered Outcomes Research Trust Fund, which was created by the Affordable Care Act, and is part of the Agency’s ongoing work to accelerate the dissemination and implementation of PCOR findings into practice. This initiative is also tied to the wider Department of Health and Human Services delivery system reform initiative to encourage Better Care, Smarter Spending, and Healthier People.

The three Centers of Excellence will focus on several areas:

How Market and Organizational Factors Influence Implementation of Innovations

Dartmouth College (Principal Investigator: Elliott Fisher, M.D., M.P.H.) is collaborating with the University of California at Berkeley, Harvard University, and the High Value Healthcare Collaborative (18 systems). This Center will use mixed methods involving existing and ongoing claims-based data, conduct a national survey of health care organizations and systems to understand the inner workings of systems and how market and organizational factors influence the implementation of biomedical, delivery system, and patient engagement innovations.

National Database to Study Health Systems Nationally

National Bureau of Economic Research (NBER) (Principal Investigator: David Cutler, Ph.D., Harvard University and NBER) is collaborating with the Health Research & Educational Trust and the Network of Regional Healthcare Initiatives. This Center will create a large national database to identify health systems in the United States and their characteristics and outcomes, as well as the evolving consolidation and integration of systems over time. The Center will use those data to study health systems nationally, with a focus on cancer care, pediatric health care delivery, dialysis, and post-acute care.

Role of Incentives, Use of Health IT, and Organizational Integration Within Systems

RAND Corporation (Principal Investigator: Cheryl Damberg, Ph.D.) is collaborating with Pennsylvania State University. This Center will examine health systems in five regions with the goal of understanding the role of incentives, use of health information technology, and organizational integration within systems and their impact on performance and evidence dissemination.

In addition, AHRQ will fund a coordinating center to help facilitate collaboration between the three Centers in the development of a national compendium of the performance of health care systems across the United States.

Page last reviewed December 2015

Internet Citation: Centers of Excellence to Study High-Performing Health Care Systems. December 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/pcor-centers/index.html