Welcome to the TPA NETWORK Research Consortium

an Industry-Wide Research Initiative to help

ERISA Plan Sponsors Evaluate and Assess New Medical Technologies and Health Innovations,

Plan Participants Obtain Leading-Edge Care,

Scientists Advance Medical Research, and

Stop-Loss Carriers Reduce Risk

Technological innovation is an essential element of American medicine…and our economy.  Studies show that new medical technologies account for as much as 30% of the escalation in healthcare costs over time…thereby making the “control” of technology possibly one of the most effective means by which to lower healthcare costs.  This objective however, has been fraught with economic, social and bioethical challenges as there are more powerful incentives to develop and diffuse technology than there are ones to control it.  Moreover, little is done in the way of conducting research focused on helping payors evaluate these emerging health innovations and treatments...and they are operating in the dark.  We intend to change this…


The Research Consortium seeks to accelerate the adoption of worthy new medical technologies and cut the time it takes to bring new health innovations from the bench to widespread clinical use...something that now takes 15+ years on average.  We do this by conducting research of value to payors that focuses on cost-effectiveness, return-on-investment, value (vs. the standard of care), medical outcomes, patient/payor satisfaction...and other metrics that aren't addressed by scientific research intended to prove efficacy  This  type of research is of critical value to payors as it provides them with empirical support for the adoption and inclusion of new and emerging innovations by their health plan that have been properly vetted and assessed.

 

 As a byproduct of this work, we help Plan Participants access cutting-edge medical treatments and provide Medical Researchers with valuable medical data and clinical research study participants. Funding generated from these latter activities provide a source of long-term sustainability that will enable us to provide our research at no cost to Plan Sponsors or Plan Participants.  In part, this will be facilitated through the introduction of the HERO Voluntary Healthcare Research Benefit described here.


Lastly, we believe that measuring an organization’s accomplishments is more important than measuring its profits.  As such, we seek to become a Certified B-Corporation that places doing social good ahead of profits.  To learn more, click here.


We are an Independent Research Collaborative Focused on Assessing New Medical Technologies and Health Innovations for ERISA Payors...

We Enable Health Plan Participants to Contribute to Medical Research (and Earn Cash, Awards and Benefits) by Sharing Their Health Data...

We Help Patients Access the Latest Medical Technologies, Treatments and Medical Experts with Clinical-Research-as-a-Care-Option Programs...


To learn more about our solutions for ERISA Plan Sponsors, Stop-Loss Carriers, Plan Participants, etc., click here:

What We Do...

Today’s Healthcare Environment is Characterized by Profound Disruption, Occurring at the Hands of Young, Industry Outsiders

The Price-Impact of Medical Technology and Innovation 


New medical technologies and emerging health innovations account for ~ 30% of the unsustainable increase in healthcare costs over time.  Many however, are not very effective or are redundant; don't improve quality of care or medical outcomes; or are not  a "value" vs. the standard of care.

Rapid Movement to

Value-Based Health Care


The move from the broken fee-for-service model to an unfamiliar/undefined value-based one is occurring at a very rapid pace.  Long-established and deep-rooted norms, distinctions and roles among and between TPAs, brokers, providers, etc. are being challenged and causing a lot of agita.

Record-Setting Investment in Disruptive Outsiders


A record-setting level of investment in technologies, solutions, services and business models is occurring...all aimed at disrupting the healthcare space by increasing efficiency, transparency and reducing cost.  Investors are backing young people, from outside the industry with new ideas and approaches. 


To learn more about our perspective on the changing healthcare ecosystem, download this document by clicking here:  

Third Party Administrators and Health Plan Sponsors are Having Difficulty Coping with the Accelerated Pace of Change


Unprecedented Volume of New Medical Advancements


Payors are struggling with how to handle the torrent of new medical technologies and innovations being put into clinical use.

To manage this, for 40 years, the large payors have relied upon proprietary, well-funded and professionally-staffed committees that few TPAs can afford or cost-justify.

Void of Payor-Oriented Research to Evidence Value


Today, new medical innovations must not only be evaluated and assessed for efficacy but also for value, medical outcomes and patient and provider satisfaction.


Almost no payor-oriented research exists to provide payors with the evidence-based support they need to justify coverage. 

New Approach and Tools Needed to Evaluate New Innovations


Measuring value, medical outcomes and patient/provider satisfaction – using real-world-evidence – requires new research approaches and tools, and a degree of scale.


Conducting this type/caliber of research is far beyond the mission, resources and capability of all but a few of the mega-TPAs. 

 

New Medical Technologies, Health Innovations,

Attitudes, Approaches and Ways of Doing Business…

The following is a list of the many new medical technologies, health innovations, etc. that the Research Consortium may research:

  • Precision Medicine and Personalized Care
  • Genetic/Genomic (DNA) Testing (Diagnostic, Prognostic, Rx)
  • Medical Cannabis and Cannabidiol (CBD)
  • Medical Wearables / Wireless Monitoring
  • Capsule Endoscopes
  • Bluetooth-Enabled Smart Inhalers
  • Tele-Nutritionist and Tele-Dietitian Consultations
  • Remote, High-Risk Patient Monitoring (RPM)    
  • Nutrigenomics (i.e., which foods to eat and to avoid)
  • Non-Invasive Liquid Biopsies
  • Companion Diagnostic (CDx) and Biomarkers
  • Neuroscience-Based Wearable to Treat Obesity

  • 3-Dimensional Printed Body Parts (stents, casts, bones)
  • NeuroAD Therapy System (to treat mild Alzheimer's)    
  • Scalp Cooling (to reduce chemotherapy hair loss)
  • Implantable Neuromodulation Device (re Sleep Apnoea)
  • Medications to Treat Hearing Loss   
  • Virtual Primary Care and Robotic Check-Ups
  • Regenerative Treatments for Orthopedic Injuries
  • Needle-Free Drug Delivery Technologies
  • Advanced Implantable and Bioresorbables Devices
  • Embracing New Attitudes Toward Health Data Ownership
  • Using EMR, Lab and Radiology Data in Plan Management
  • Facilitating Patient Contributions to Medical Research

The Research Consortium will also conduct research to reassess many commonly employed yet questionable treatments such as dialysis,  chemotherapy, spinal injections, hormone replacement, elective C-sections, PSA screening, tests (CT scans, ultrasounds and pre-op tests), etc.

We Urgently Need More Medical Research but Our Clinical Research Systemis Broken and in Desperate Need of an Overhaul


We are Living Longer,

but Getting Sicker


While we are certainly living longer, we are also getting sicker.  As evidence of this, the number of people age 65 and older having four or more health conditions is expected to double over the next fifteen years.


This tax on our healthcare system will create a need to find new ways to more effectively and efficiently research, understand and manage disease..., ergo, the need and demand for more medical research. 

We Urgently Need More

 Medical Research


Over the next five years, we in the U.S. will increase our investment in medical research and development to $200+ billion, an increase of 30% in fewer than ten years.


Despite this investment, during the past five years we have seen only half as many new molecular entities (medications) reach the market than in the previous five years.   To keep up with the demand for new drugs, these results must be greatly improved.

Failure of the

Clinical Trial Processes


The clinical trial process is broken with low study participation rates, high abandonment and termination rates, enormous time delays and extraordinary financial waste.  Indeed, little has been done to change the medical research process in the more than 70 years since it was established.

 

Our medical research process needs to be reinvented to accommodate the very urgent need for additional medical research.  

There is a Slow Motion Crisis Brewing in Medical Research that Impacts Us All by Slowing Down Critical Healthcare Innovation


Half of the New Drugs We Need are Not Being Developed


In the past five years less than half as many new drugs have gotten to market versus the previous five years.  Less than 10% of the drugs that start the clinical trials process eventually earn FDA approval.

Many Research Studies Suffer from Low Study Participation


Nearly 20% of all clinical research studies are prematurely terminated due to participation shortfalls. A whopping 80% of all research study sites are unable to recruit sufficient numbers of study participants.

We are Unable to Recruit

Research Study Participants


We need 50+ million research participants to complete the 125,000 studies already underway in the U.S. alone…and have less than 30% of the research participants we need to populate these studies.

Although the Demand for Participants is Great, and Patients are Abundant, the Cost of Clinical Research Recruiting is Exorbitant

In great part, the enormously high cost of recruiting participants for clinical research studies is a result of neither physicians nor their patients learning about research participation opportunities: this (very correctable problem) greatly impacts the amount of research conducted and the development cost of bringing new medical technologies and health innovations to market.

The Good News: Patients are Interested in Learning More About and Participating in Clinical-Research-as-a-Care-Option Programs...

Patients are Willing to Participate in Research


Recent surveys indicate that more than 70% of respondents would be either "interested" or "very interested" in participating in a medical research study if recommended to do so by their doctor; unfortunately most doctors and patients are not so informed.

Patients Want to Know About Research Opportunities


National surveys show that ~ 80% of respondents believe it’s important to be made aware of the chance to participate in medical research and more than 85% believe that study participation opportunities should be a routine part of standard care.

Patients are Very Satisfied with Participating in Research


Multiple research study participant surveys evidence a 90% patient satisfaction level, improved medical knowledge; significantly better or improved quality of care; reduced overall health care costs; and decreased complications and hospital admissions.

...and Patients are Very Willing to Share Their Medical Data

with Both Medical Researchers and Their Health Plan




Patients Willingness to Share Medical Data with Researchers


More than 70% of survey respondents said they were willing to selectively share their medical data with certain research groups.   

Patient Interest in Obtaining Actionable Information


Nearly 70% of survey respondents were most interested in receiving feedback about potential risk factors gleaned from their data.

Patient Willingness to Share Medical Data with Health Plan


More than 50% of the patients willing to share their medical data with researchers for insight would share it with their plan.

The Research Consortium conducts research of value to ERISA Plan Sponsors; helps Plan Participants access leading-edge medical care; and provides Medical Researchers with valuable medical data and access to clinical research study participants.  We seek to accelerate the adoption of emerging medical technologies and reduce the time it takes to bring new health innovations from the work bench to widespread clinical use...something that now take more than 15 years on average.

We are an Independent Research Collaborative Focused on Assessing New Medical Technologies and Health Innovations for ERISA Payors...

We Enable Health Plan Participants to Contribute to Medical Research (and Earn Cash, Awards and Benefits) by Sharing Their Health Data...

We Help Patients Access the Latest Medical Technologies, Treatments and Medical Experts with Clinical-Research-as-a-Care-Option Programs...

The Research Consortium provides something

of value to everyone in the health care ecosystem.

To learn more about our solutions for TPAs, Stop-Loss Carriers

Plan Sponsors,PlanParticipants and Researchers, click here:

To learn about our unique solutions and the

Research Consortium HERO Voluntary Healthcare Research Benefit click:

Ready to Join the Initiative, Learn More About the Research Consortium

and the HERO Voluntary Healthcare Research Benefit ?

.