"Evidence Roadmaps" Launched in Response to Medicare Listening Report

In 2013, AcademyHealth’s Translation and Dissemination Institute launched its first major activity, a “Listening Project” aimed at identifying the most pressing health services research needs of leaders in health policy and health care delivery for the coming three to five years. Its goal was, and is, to foster greater interaction among the producers, users, and funders of health services research to spur the development and use of more relevant and timely evidence. As such, it supports AcademyHealth’s work to improve health and health care by generating new knowledge and moving that knowledge into policy and practice.

The first Listening Project report, published in February 2014, focused on the questions facing Medicare policymakers and identified research and data needs around three themes:

• Research is needed to address new organizational structures like Accountable Care Organizations and consolidated markets, and to address persistent issues like health care costs.
• Data gaps impede the study of health care quality, Medicare Advantage and physician practice.
• The way research is conducted is changing; there's a need to better understand the promise and potential pitfalls of electronic data, rapid-cycle research, and comparative effectiveness research.

The report also offered advice to the community of health services researchers producing evidence on Medicare, including a call to better understand the impact of politics, role of relationships, and the need for timely evidence and information.

In response to what we heard from Medicare policymakers, AcademyHealth today released a series of Evidence Roadmaps that identify existing resources related to the identified gaps. These Roadmaps represent a selected, minimal set of key resources rather than a comprehensive list of relevant research. As such, the Roadmaps are intended to help policy analysts and other research users better understand whether a perceived research gap represents an actual lack of evidence or failure of existing evidence to reach the policy arena, that is, a failure of adequate translation and dissemination.

For the Medicare project, we found at least some existing data and literature to support nine Roadmaps, which include a mix of data sources, systematic reviews, individual studies, grey literature, and ongoing research. While the evidence presented in the Roadmaps supports our hypothesis that the field of health services research can do to more get existing research results to policymakers, they also confirm the Listening Project report’s conclusion that Medicare policy questions offer important opportunities for researchers to contribute new evidence to the policy process.

The series of Roadmaps offering a glimpse of what is currently known about Medicare includes:

1. Understanding Medicare Cost Growth
2. Care Coordination
3. Medicare ACOs and the Health Care Marketplace
4. Medicare Beneficiary Behavior and Decision Making
5. End-of-Life Care and Medicare’s Hospice Benefit
6. Changes in Physician Practice
7. Medicare Trends in Specialty Drug Costs and Use
8. Medicare Advantage
9. The Internal Workings of Medicare Accountable Care Organizations

Going forward, we intend this body of work – the Listening Project reports and follow-on Roadmaps – to offer a platform for linking policymaker needs to available evidence, and a resource for the community of evidence producers to identify potentially relevant research questions. In the coming weeks, look for a new Listening Project report that the Institute has undertaken with support from the Robert Wood Johnson Foundation and the Medicaid and Chip Access and Payment Commission (MACPAC) focused on the research needs of Medicaid policymakers.

You can review the Roadmaps and learn more on our website.