The IRS recently announced updates to PCORI fees on October 29, 2025. See the PCORI Funding and Research section for more details.
Two key factors driving up healthcare costs are patients’ limited understanding of medical procedure costs and their minimal participation in healthcare decisions. However, the landscape is changing due to the rise of healthcare consumerism. This movement aims to improve the quality of healthcare services while enhancing efficiency and cost-effectiveness. By empowering patients with decision-making authority and purchasing power, it seeks to achieve these objectives.
Organizations like the Patient-Centered Outcomes Research Institute (PCORI) are supporting this initiative by providing resources that encourage patient engagement in healthcare decisions. Learn more about PCORI below.
Content Guide
About PCORI
PCORI is a nonprofit research group that funds studies to help healthcare consumers make PCORI helps people make better-informed healthcare choices. Its main goal is to give healthcare consumers the information they need to make decisions that lead to their desired health outcomes. To achieve this, PCORI:
- Funds research led by patients, caregivers, and the broader healthcare community
- Creates and shares evidence-based information based on the research it supports
- Works to improve healthcare delivery and outcomes
- Helps people make informed healthcare decisions
PCORI believes that engaged patients, caregivers, clinicians, and other healthcare stakeholders are crucial for producing the most valuable research results. They see the researchers they fund, patients, and other healthcare stakeholders as equal partners, not just research subjects.
PCORI Priorities and Programs
PCORI’s research priorities, outlined in the organization’s National Priorities for Research, focus on five key areas:
- Assessment of prevention, diagnosis, and treatment options
- Improving healthcare systems
- Communicating and disseminating research results
- Addressing disparities in prevention, diagnosis, and treatment effectiveness
- Accelerating methodological research in patient-centered outcomes
The organization’s programs to address these priorities include:
Clinical Effectiveness and Decision Science (CEDS)
CEDS aims to fill gaps in clinical knowledge by producing valid evidence to compare the effectiveness of different treatment options.
Healthcare Delivery and Disparities Research (HDDR)
HDDR addresses two of PCORI’s five national research priorities for improving healthcare systems and addressing disparities. The program compares patient-centered approaches to improve healthcare effectiveness and efficiency in providing equal access to care.
Evaluation and Analysis (E&A)
E&A’s goal is to ensure continuous improvement in the quality, efficiency, and effectiveness of PCORI’s work through:
- Assessing the work’s impact
- Understanding what PCORI funds
- Informing PCORI process improvement
- Building evidence supporting the science of engagement
Engagement
Engagement brings together all the various healthcare stakeholders to help set research priorities and evaluate applications. Its primary goal is to ensure PCORI funds and conducts research relevant to its priorities.
Research Infrastructure
Research Infrastructure spearheads the creation of a national network, PCORnet, to foster clinical effectiveness research studies and develop faster, more cost-effective research methods to improve healthcare and healthcare delivery.
PCORI Funding and Research
PCORI Funding Fees
As a nonprofit organization, PCORI relies on outside funding. Initially, the Affordable Care Act required certain insurance companies and employers to pay a fee to the nonprofit. After the ACA mandate expired in September 2019, Congress voted to extend PCORI funding for another ten years.
The annual PCORI fee for an insurance company or employer is based on the average number of people covered under their policy or plan and the plan year’s ending date. To determine the amount due, entities multiply the average number of plan lives by a set amount, which is determined by Health and Human Services. The IRS announces the updated PCORI fee every year.
- For plan years ending between October 1, 2025, and September 30, 2026, the PCORI fee is $3.84 per covered life
- For plan years ending between January 1, 2025, and September 30, 2025, the fee is $3.47 per covered life
The payment is due at the end of the seventh month following the end of the plan year, which for most plans (calendar-year plans) is annually on July 31. The fee is filed using IRS Form 720, the Quarterly Federal Excise Tax Return.
Research
One indication of the quality of PCORI’s work is the growing number of funded research studies being summarized in leading medical journals and presented at major scientific meetings. Essentially 100% of PCORI-funded research results are published in peer-reviewed journals within 90 days of peer review completion, making findings publicly available faster than traditional research.
PCORI-funded projects include such recent examples as systematic reviews on doula support during pregnancy and nonpharmacological interventions for sleep disorders in individuals with ADHD, as well as studies examining social isolation among older adults and health communication strategies for COVID-19 vaccine uptake.
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