NIHCM Awards More Than $500,000 to Support Research on GLP-1s, Hospital Competition, Value-Based Care, the Health Care Workforce, and More.

Washington, D.C., April 17, 2025 – The new cohort of NIHCM Research Grantees stands to break new ground and produce powerful evidence on multiple drivers of health care costs and quality. The 11 grantees will investigate the impact of increasing hospital consolidation, pharmaceutical marketing practices, novel approaches to integrated primary and mental health care, the extent of price variation, and the effectiveness of value-based payment models, along with other key managed care topics.

“We are pleased to support the work of this extraordinary group of researchers who are sure to inform and advance NIHCM’s core mission—helping organizations, policymakers, and other stakeholders improve the affordability and quality of US healthcare, while improving health outcomes,” said Avik Roy, CEO of NIHCM.

The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to transforming health care through evidence and collaboration.

2025 Grantees:

Using Transparency in Coverage Data to Understand Health Care Price Variation
In many US health care markets, private insurance prices vary considerably, contributing to high health care spending and frustration for consumers. This research team will use recently mandated Transparency in Coverage data to describe how prices vary across procedures, providers, insurers, and markets. They will also identify the provider, insurer, and market characteristics associated with these price differences.

• Christopher Whaley, Brown University
• Benjamin Chartock, Bentley University
• Daniel Arnold, Brown University
• Nandita Radhakrishnan, Brown University

Spillovers from Commercial Drug Coverage to Medicare Utilization
Government-regulated health plans, like Medicare and Medicaid, coexist alongside commercial plans, serving different patients but often contracting with the same facilities and providers. This study will investigate the spillover effect of commercial insurance on Medicare utilization in Part B. The team will look at commercial coverage of doctor-administered drugs to see if reduced commercial coverage leads to reduced Medicare utilization, despite Medicare covering almost all physician-administered drugs, and seek to understand what is driving the spillover.

• Josh Feng, University of Utah
• Emma Dean, Dartmouth College
• Luca Maini, Harvard Medical School

Hospital Competition, Vertical Integration, and Participation in Value-Based Payment Programs
The US hospital market has become increasingly concentrated through extensive vertical and horizontal consolidation over the past decades. This study aims to examine whether hospital market competition and hospital-physician vertical integration are separately and jointly associated with hospitals’ participation in value-based payment programs. This study will provide new evidence on the relationship between hospital competition and VBP participation, overall and across different payers, and on how the relationship varies across hospitals’ levels of integration with physicians.

• Kate Bundorf, Duke University
• Kun Li, Duke University
• Yucheng Hou, The University of Texas Health Science Center at Houston

The Rise of Compounded GLP-1 Weight Loss Medications: A Landscape Analysis of the Direct-To-Consumer Market
During GLP-1 shortages, compounded versions of the drugs gained popularity as a cheaper alternative to sought after weight loss drugs. This study will look at the rise in compounded GLP-1 products advertised and sold to consumers by telehealth platforms, weight loss clinics, and medical spas. It will identify and describe the direct-to-consumer market for these products in the US, including advertising claims regarding the safety and efficacy of compounded GLP-1 products.

• Michael DiStefano, University of Colorado
• Kavita Nair, University of Colorado
• Gina Moore, University of Colorado
• Joseph Saseen, University of Colorado

Impact of Medicare Advantage Value-Based Contracts on Adoption of Remote Patient Monitoring for Hypertension Management and Patient Outcomes
Hypertension affects nearly half of the adult population in the US, posing significant health and economic challenges. The COVID-19 pandemic has accelerated the adoption of remote patient monitoring for hypertension management (RPM-HTN). This study will analyze the impact of Medicare Advantage value-based contracts on the adoption of RPM-HTN and patient outcomes, compared to traditional Medicare fee-for-service models.

• Donglan Stacy Zhang, NYU Grossman Long Island School of Medicine

Cost of Product Discontinuations in the Pharmaceutical Industry
Older drugs often provide more affordable treatment options due to higher market competition after the patent expires or because they are exposed to price regulations. This research team will investigate pharmaceutical firms’ decisions to strategically discontinue old drugs when introducing new or improved versions. The study will examine the impact of voluntary drug discontinuations, which are unrelated to safety concerns, on adherence to treatment, cost of treatment, and consumer surplus.

• Tuba Tuncel, Florida State University
• Pierre Dubois, Toulouse School of Economics
• Elisa Philip Gentry, Florida State University College of Law

Impact of Integrated Primary Care and Mental Health Models of Care on Health Services Utilization and Costs for Medicaid Beneficiaries with Mental Health Conditions or Substance Use Disorders
Over 64.5 million nonelderly adults have a mental health condition or substance use disorder, representing $88.4 billion in annual healthcare expenditures. Integrated primary care and mental health care models aim to improve mental health care while decreasing the cost of care. This study will look at how the utilization and costs of mental health care for those who receive mental health care through integrated care models compare to those who receive care from external community providers, and how the availability of mental health providers impacts the delivery of mental health services.

• Ann Annis, Michigan State University
• Rebecca Piasecki, University of Michigan
• Dawn Goldstein, Michigan State University

Value-based Precision Medicine: Assessing the Financial Implications of Medicare’s Coverage Policy for Advanced Genetic Testing
In recent years, the number of genomically targeted therapies and genetic tests has grown significantly, with advances in precision medicine driving notable improvements in patient outcomes and drug safety. This study will assess the shift from single-gene testing to next-generation sequencing (NGS), a more advanced and comprehensive form of genomic testing, and explore the potential value associated with adopting this technology, particularly in terms of healthcare spending. Additionally, the team will also analyze the relationship between NGS-related insurance outcomes and Medicare’s national coverage policy for NGS.

• So-Yeon Kang, Georgetown University School of Health and Lombardi Comprehensive Cancer Center
• Carole Roan Gresenz, Georgetown University School of Health and McCourt School of Public Policy
• Marc D Schwartz, Georgetown University School of Medicine and Lombardi Comprehensive Cancer Center
• Chul Kim, Georgetown University School of Medicine and MedStar Health

Socio-economic and Healthcare Factors Associated with the Provision of Direct Primary Care Services in the United States
The Direct Primary Care (DPC) model, a subscription-based model that provides access to enhanced primary care services, is gaining traction as a solution to the challenges facing the current primary care system in the U.S. This study will document the growth and characteristics of DPC practices, analyzing trends, practice features, and geographic distribution while assessing the impact of state regulations on DPC expansion. The research team will explore how DPC locations correlate with geographic and socioeconomic factors and examine the broader impact of DPC on community healthcare utilization and the availability of other healthcare services.

• Revathy Surya Narayana, UT Southwestern Medical Center
• Megan Hyland

Patient Outcomes and Cost Variations across Different Nurse Practitioner Scope of Practice Levels
In several states, executive orders issued during the COVID-19 pandemic temporarily permitted nurse practitioners to work autonomously, without the oversight of a physician. This study aims to explore how different levels of authorized nursing practice across the country affected patient outcomes, subsequent health care utilization, and associated costs.

• Cynthia Chih-Ying Li, University of Texas Medical Branch
• Peter Cram, University of Maryland School of Medicine
• Md Ibrahim Tahashilder, University of Texas Medical Branch
• Yong-fang Kuo, University of Texas Medical Branch
• Letitia Graves, University of Texas Medical Branch

Quantifying the Population Health Impact of New Drugs Adopted by Medicare
Increases in the prices of prescription drugs have been a significant cause for concern for patients, providers, payers, and policymakers. This study will evaluate the net population health effects of Medicare spending on pharmaceuticals, and will consider the health gains from using new drugs covered by Medicare and the health opportunity costs associated with paying for them.

• Irene Papanicolas, Brown University
• Huseyin Naci, London School of Economics and Political Science
• James Lomas, University of York
• Dan Ollendorf, Tufts University School of Medicine