The $787 billion stimulus package signed by President Obama on Tuesday dedicates $1.1 billion for head-to-head research to determine which drugs, devices, and procedures are most effective and carry the lowest risk.

The money will be split between the National Institutes of Health, the Department of Health and Human Services, and the Agency for Healthcare Research and Quality.

The legislation also creates a board, called the Federal Coordinating Council for Comparative Clinical Effectiveness Research, to oversee and direct the studies, which will likely include literature reviews as well as independent trials.

This report from the Commonwealth Fund Commission on a High Performance Health System offers recommendations for a comprehensive set of insurance, payment, and system reforms that could guarantee affordable coverage for all by 2012, improve health outcomes, and slow health spending growth by $3 trillion by 2020-if enacted now to start in 2010. Central to the Commission's strategy is establishing a national insurance exchange that offers a choice of private plans and a new public plan, with reforms to make coverage affordable, ensure access, and lower administrative costs. Building on this foundation, the report recommends policies to change the way the nation pays for care, invest in information systems to improve quality and safety, and promote health. By stimulating competition and delivery system changes aimed at providing more effective and efficient care, the policies could yield higher value and substantial savings for families, businesses, and the public sector.

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