NIHCM Gives $500,000 to Research Grantees Studying Prescription Drug Costs, Telehealth and Opioids, Private Equity in Health Care, and More

Washington, D.C., February 14, 2024 - The new cohort of NIHCM Research Grantees will investigate a broad range of timely and pressing health issues to generate evidence and new solutions for improving health care, while lowering care costs. Several studies will tackle complex factors affecting access to prescription drugs and affordability. Other work will seek new knowledge on improving kidney care and understanding the impact of private equity acquisition on care. The NIHCM Foundation supports innovative, independent, investigator-initiated research. The Foundation gives $1 million in grants each year to researchers and journalists.

“The list of grantees we are excited to support this year stand to accelerate progress on addressing the nation’s opioid crisis, understanding the impact of AI on health care spending and outcomes, and other important elements shaping health care costs and quality,” said Nancy Chockley, Founding President and CEO of NIHCM.

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

2024 Grantees

New Uses of Existing Drugs: The Effects of FDA Regulation and Off-Label Drug Use on Incentives for Pharmaceutical Innovation
Approximately 90% of approved drugs have multiple possible uses. Policymakers and researchers argue that drug repurposing — identifying new uses for existing drugs — can offer a lower-cost, quicker alternative for bringing treatments to market. This research team will conduct a comprehensive analysis of the economic factors shaping drug repurposing and the effects of drug repurposing on patients’ utilization of care and outcomes. The findings will inform researchers, policymakers, and practitioners.

• Jennifer Kao, University of California, Los Angeles

• Charu Gupta, University of California, Los Angeles

Market, Organizational, and Policy Drivers of Hospital Price Markups for Specialty Drugs
While policymakers are paying attention to drug prices and profits in the retail distribution channel, less is known about the hospital "buy and bill" channel that accounts for one-third of drug expenditures. This research team will quantify trends in price markups and profit margins for hospitals and physician practices from 80 infused drugs, biologics, and biosimilars. This study has implications for policymakers and insurers.

• James Robinson, University of California, Berkeley

• Chris Whaley, Brown University

How Does Interchangeability Impact Biosimilar Adoption?
Biosimilar adoption could reduce health care spending and improve medication affordability. One barrier to adoption is that pharmacists are not permitted to substitute biosimilars for original biologics unless the biosimilar is deemed “interchangeable” by the Food and Drug Administration. This study will evaluate how interchangeability affects biosimilar adoption, whether the effects are different for new versus existing patients, and the role played by state substitution policies in mediating these effects. The study may offer valuable insights to policymakers assessing substitution laws.

• Pragya Kakani, Weill Cornell Medicine
• Luca Maini, Harvard Medical School

Private Equity’s Effects on Primary Care Practices Participating in Medicare Advantage
Private equity (PE) investment is increasingly focused on primary care practices participating in Medicare Advantage (MA) risk-bearing capitation models. This study will provide new information on the specific mechanisms by which PE firms may affect provider behavior under the unique financial incentives in MA and the effects on quality of care and patient outcomes. Understanding PE’s impact on the MA program is critical to informing ongoing policy discussions.

• Jane Zhu, Oregon Health & Science University
• Zirui Song, Harvard University

Spillover Effects of Private Equity Acquisitions of Physician Practices on Local Market Competitors: Implications for Access to Care
The acquisition of physician practices by private equity (PE) firms has grown rapidly, yet little is known about the effects on providers in the same market that do not get acquired. This research will use Medicare claims data to examine the impact of PE acquisitions on patient access, with a focus on complex surgical cases in ophthalmology. The findings will explore the aggregate effects of PE in health care and inform policy.

• Yashaswini Singh, Brown University
• Durga Borkar, Duke University

A Double-Edged Sword: Evaluating the Role of Telehealth Expansion and Contraction in the US Opioid Crisis
Individuals who visit multiple providers to procure additional opioid prescriptions purchase 4% of all dispensed opioid prescriptions in the US. This team will examine the impact of the expansion and subsequent contraction of telehealth services (due to COVID-19 public health emergency declarations) on opioid prescriptions, rates of doctor shopping, treatments for opioid use disorder, and overdose deaths. The results may inform policymakers, federal agencies and state regulators working on guidelines for the expansion of telehealth services.

• Niam Yaraghi, University of Miami/Brookings Institution

The Effect of AI-Enabled Clinical Software on Health Care Spending and Health Outcomes
Artificial Intelligence (AI) is poised to become a major part of health care. This team will look at the Centers for Medicare and Medicaid (CMS) reimbursement data for six AI-enabled applications to provide the first causal evidence of the impact of AI-enabled clinical software on health care utilization, spending, and health outcomes. The findings may be of immediate and long-term use to CMS and other payers as they determine reimbursement policies, as well as health systems and clinicians considering adopting AI applications.

• Anna Zink, Chicago Booth Center for Applied AI, University of Chicago
• Hannah Neprash, University of Minnesota
• Michael Chernew, Harvard University

Impact of Capitation Payment Models on Kidney Health Outcomes
Chronic kidney disease (CKD) affects 37 million Americans and leads to end-stage renal disease (ESRD), which accounts for over $50 billion in Medicare spending. This research team will evaluate the impact of the Center for Medicare and Medicaid Innovation’s Kidney Care Choices payment model on CKD care delivery and kidney health outcomes. The study results will provide novel evidence on the impact of capitation payments, which provide reimbursement on a per-member per-month basis.

• Sri Lekha Tummalapalli, Weill Cornell
• Amol Navathe, University of Pennsylvania
• Yuvaram Reddy, University of Pennsylvania

Evaluating the Effectiveness of the Hospital Price Transparency Rule in Price Reduction
With US health care spending exceeding $4.3 trillion in 2021, understanding the nuances of hospital pricing in the wake of regulatory changes is critical for future policy interventions. This team will evaluate the impact of the Hospital Price Transparency Rule on hospital pricing strategies, focusing on 70 shoppable services. The study’s findings will offer insight into the rule's effectiveness in altering hospital pricing practices.

• John X Jiang, Michigan State University
• Isabel Wang, Michigan State University
• Ge Bai, Johns Hopkins University