Beyond gridlock and gloom

Research on innovations has a compelling future

After a year of government gridlock, lingering gloom over the economy, and a torrent of changes in the health care industry, this is the most compelling time ever to study innovation in health care. Some might say it’s been too exciting. Take last summer. After expanding operations for projects funded by the 2009 federal stimulus bill, GHRI experienced a scary period when we went for more than six months without any word of new federal grants. The problem? Congressional budget wrangling caused the National Institutes of Health (NIH)—GHRI’s prime funder—to withhold awards. Meanwhile, GHRI managers were talking “worst-case scenario” budget cuts. Fortunately, by fall, Congress passed a 2011 budget and revenue began flowing our way again. By year’s end we had raised more than $42 million in annual revenue—slightly exceeding our total for 2010.

Political theatrics aside, GHRI starts 2012 on solid ground. Much of our stability comes from grants for research in areas where we’ve long prospered: cancer screening, chronic care, patient safety, and healthy aging, to name a few. It makes sense for NIH to keep investing in studies to improve quality and safety in these areas.

But government-funded health researchers must also respond to the major crisis brewing: Health care costs keep spiraling. And if access to care eludes people because it costs too much, the economy is tanking, or Medicare and Medicaid are broken, we must do more than improve the quality and safety of care—or else our nation won’t fulfill its obligation to provide for its people’s general welfare.

So while GHRI begins 2012 with stable funding, we see more change coming. The New Year will bring a Supreme Court decision on the Affordable Care Act. Presidential and Congressional elections could break the gridlock over taxes, spending, and regulation.

Washington Post health policy journalist Sarah Kliff recently dubbed 2011 “the year of getting ready” as the health care industry prepared for “a wave of changes ... moving toward more integrated and coordinated care.” She quoted a former Obama advisor: “There’s this feeling in the health care world that something big is going to happen,” whether the Affordable Care Act is upheld or overturned, strengthened, weakened, or replaced. “The fiscal situation is forcing the government to act and businesses to ask. So people are changing their business plans and repositioning.”

Whatever happens, those prepared to engage and study ongoing changes can elicit new knowledge to move our nation’s health care system forward.

How are we at GHRI preparing? We’re putting the final touches on a three- to five-year strategic plan that we’ll present to the Group Health Research Advisory Board later this month. The plan capitalizes on the Institute’s main strengths: our access to extensive health care and claims data; our collaborative relationships with colleagues at Group Health and other learning health care organizations; our world-class expertise in research methods; and our rigorous interdisciplinary approaches to studying change in health care.

We’re also focusing on diversifying our funding portfolio beyond our traditional sources such as the NIH and the Centers for Disease Control and Prevention. One example: a recent Bill & Melinda Gates Foundation grant to study vaccine hesitancy. And we’re seeking support from new government agencies focused on fast-paced health care improvements: the new Center for Medicare and Medicaid Innovation (CMMI) and the Patient-Centered Outcomes Research Institute.

CMMI submission requirements are particularly challenging: Applicants must design projects that propose to address “quadruple aims”: improve quality, increase access, lower cost, and build a more sustainable provider workforce. But this suits GHRI, because we work within Group Health, an integrated health plan where all four aims serve a real-world population—and our mission is to improve health and health care at Group Health and beyond.

So despite uncertainty about the year ahead, we can greet 2012 with optimism, knowing that as changes abound, we’re in an optimal spot to promote the innovation that Group Health and the nation need.

—Eric