for having reduced the magnitude of these distortions, in a revamp of the drg methods under mark mcclellan'sleadership, but the distortions in hospital payment remain for many private payers, who are not using drg's, either the old system or the new updated medicare system, but they are paying on the basis of per diems and discouldn'ted charges. so for privately insured patients, the incentives for hospitals are still there. now, physician procedures involving new technology are more profitable for physicians than evaluation and management services. now there are two aspects to this and this is getting into a little bit of detail. the medicare fee schedule is calibrated so that a big component of it is the physician work or really the time, effort, intensity that physicians personally put into the services and the other major components is what we call the technical or the facility or the practice expense component. ba

now i'd like to introduce mark mcclellan who i'm sure is also well known to all of you. he is the director of the ingle brooks center at brookings where he draws on his public-sector experience having led both cms and fda. of course he also brings his background as a physician and an economist to that role. mark most recently has been playing a key role in the development of the dolby girt daschle plan, and important bipartisan agreement on health care reform. markle described some of the multi-payer initiatives that he's involved in that also can serve as a model for health care reform. >> thanks, nancy. it's great to be here this morning with all of you. how are we doing on slides? coming up. okay. like i said, this is a very distinguished panel. i'm so glad people are taking time to be here and that we are seeing so much discussion around payment reform and improving health care works as part of health care reform. i am going to talk about that, as nancy mentioned, focusing on things like accountable care and multi-stakeholder approaches to doing this. that it is very

i'm mark mcclellan here at brookings and on behalf of bob rubin and the hamilton project we'd like to welcome you to today's event on one of the key issues for healthcare reform. implementing comparative effectiveness research. we're delighted to have such distinguished participants to discuss this issue today and that, of course, includes all of you here, all of you in the overflow room and i know we've got a lot of participants online as well. comparative effectiveness research has vaulted to the front lines of the healthcare debate as you'll hear from some of your upcoming speakers it could be a game changer a key part of bending the healthcare cost curve and comparative effectiveness research is moving forward. the american recovery investment center the economic stimulus legislation invested $1.1 billion in federal initiatives to conduct, comparative effectiveness and research and expand current activities. this includes an effort to coordinate new and existing efforts in comparative effectiveness research. the legislation created a new federal coordinating council which has begu

morning everyone, i would like to welcome new to this brookings institute this morning, im mark mcclellan, director of the engelberg center for health care reform at brookings and on behalf of bob and the hamilton project we would like to welcome you to today's events on one of the key issues of health care reform. implementing comparative effectiveness research here and we're delighted to have such distinguished participants to discuss this issue and that, of course, includes all of you here, in the overflow room and i know we have a lot of participants, as well. comparative effectiveness research has vaulted to the front lines of the health care reform debate and as you'll hear from some of our upcoming speakers it could even be a game changer come a key part of bending the health care cost curve and comparative americaness research is moving toward. the american recovery and reinvestment act and a stimulus legislation of us at $1.1 billion in federal initiatives to conduct, comparative effectiveness research and expand current activity. this includes an average two cornyn a new and exi