Kuzneski Insurance Group Blog

What is PCORI?

Written by Kuzneski Editors | December 22, 2016

You may have seen this acronym “PCORI” and know there is a fee associated with it, but what does it actually mean and why are you potentially liable for paying for it?

Why was PCORI established?

People have often faced medical problems that traditional research hasn’t been able to solve. On a daily basis, patients and their caretakers ask physicians for answers but the information isn’t available. The Patient-Centered Outcomes Research Institute was created to help address these challenges.

Why are there fees associated with this?

Fees are imposed on plan sponsors of applicable self-insured health plans to support research to evaluate and compare health outcomes. PCORI also addresses the clinical effectiveness of certain medical treatments, services, procedures and drugs.

How much does my business have to pay?

If your company is an eligible self-insured plan provider, the fee has been changed to $2.26 multiplied by the average number of lives covered under the plan. This only applies to plan years ending on or after October 1, 2016 and before October 1, 2017. If your plan does not fit this timeline and ends later than October 1, 2017, the fee will be adjusted for inflation at a later time.

Contact us to talk about your plan and to see if you are required to pay, how you pay, and what your total amount should be. If you have questions regarding PCORI’s research, please visit their website.