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Gina Pferdehirt
Director, Public Relations & Community Relations
UPMC Health Plan

UPMC Center for High-Value Health Care Approved for $3.8 Million in Research Funding for Study of Patients with Complex Care Needs

Funds awarded by the Patient-Centered Outcomes Research Institute (PCORI) will support Medicaid and dual-eligible patients with multiple chronic conditions

PITTSBURGH (Sept. 14, 2017) – The UPMC Center for High-Value Health Care today announced it has been approved for a $3.8 million funding award by the Patient-Centered Outcomes Research Institute (PCORI). This announcement marks the third time in the past five years that the UPMC Center for High-Value Health Care has been selected to receive prestigious PCORI funding, totaling more than $7.5 million.

The UPMC Center for High-Value Health Care promotes value-driven health care by deploying innovations developed by the UPMC Insurance Services Division in partnership with providers, patients, and other stakeholders.

UPMC Health Plan ranks ahead of all seven other Pennsylvania health insurers in overall member satisfaction and also scored significantly higher than the regional average. The 739 overall score ranks UPMC Health Plan as the ninth highest-rated health plan in the U.S.

The PCORI funding will allow researchers to study the effectiveness of two approaches for deploying an evidence-based integrated care model that supports the most vulnerable patients. This model was developed by UPMC Health Plan and Community Care Behavioral Health for Medicaid and dual-eligible beneficiaries with multiple chronic conditions who often have multiple health-related and psychosocial needs.

One approach utilizes nurses and social workers employed by UPMC Health Plan to provide intensive, in-person support services for patients in their homes and communities, and the other approach primarily utilizes telehealth, remote monitoring, and other web-based health tools available through UPMC Health Plan.

Over the course of the next four years, researchers will study the impact of these “high touch” and “high tech” deployment techniques on outcomes such as hospital readmission, patient activation, and health status. A collaborative research team from UPMC Health Plan, Community Care Behavioral Health, and UPMC Provider Services will participate in the study along with patients that are representative of the Medicaid and dual-eligible populations.

“Thanks to the PCORI funding, we will be able to better understand how innovative deployment strategies can enhance the ability of health care systems to support these patients through an integrated model of care,” said Dr. James Schuster, chief medical officer for Medicaid and behavioral services at UPMC Health Plan. “The results of this study will allow us to enhance patient engagement, support patients with programs that are best suited for them, and improve overall health outcomes.”

The UPMC Center for High-Value Health Care study was selected for PCORI funding following a highly competitive review process in which patients, clinicians, and other stakeholders joined clinical scientists to evaluate the proposals.

“The UPMC Center for High-Value Health Care project was selected for PCORI funding for its scientific merit and commitment to engaging patients and also for its potential to fill an important gap in our health knowledge related to this at-risk group of individuals,” said Joe Selby, MD, MPH, executive director of PCORI. “We look forward to following the study’s progress and working with the UPMC Center for High-Value Health Care to share the results.”

The UPMC Center for High-Value Health Care received $1.8 million from PCORI in 2013 to study strategies that engage adult Medicaid beneficiaries with serious mental illness in new approaches to health and wellness. In 2014, PCORI awarded $2.1 million in funding to the Center to compare the effectiveness of two shared decision making approaches for individuals with serious mental illness and their prescribers.

This year’s award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.



PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.

About UPMC Insurance Services Division

The UPMC Insurance Services Division is owned by UPMC (University of Pittsburgh Medical Center) a world-renowned health care provider and insurer based in Pittsburgh, Pa. As a provider-led organization that is part of an integrated health care delivery system, the UPMC Insurance Services Division is committed to providing its members better health, more financial security and the peace of mind they deserve. The UPMC Insurance Services Division partners with UPMC and community network providers to produce a combination of knowledge and expertise that provides the highest quality care at the most affordable price. The UPMC Insurance Services Division – which includes UPMC Health Plan, WorkPartners, UPMC for Life, UPMC for You, UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance and workers' compensation products and services to more than 3.2 million members. For more information, visit www.upmchealthplan.com.

About the UPMC Center for High-Value Health Care

The UPMC Center for High-Value Health Care, housed within the UPMC Insurance Services Division, translates the work of the UPMC Health Plan, Community Care Behavioral Health, and the organization’s additional integrated partner organizations into evidence-based practice and policy change for improving health care quality and efficiency and the overall health of the population. Many activities are conducted in UPMC’s unique payer-provider laboratory and supported through grants and contracts carried out in partnership with community organizations and government agencies. UPMC is a global health enterprise and one of the nation’s largest integrated health care delivery and financing systems. UPMC and its Insurance Services Division recognize and embrace the value of collaboration in achieving an equitable, high-quality, and efficient health care system that meets the needs of diverse populations. For more information, visit www.upmchighvaluehealthcare.com.