By definition, participation in clinical trials is limited to those individuals who conform to the applicable clinical protocol so as to assure the accuracy of the findings. Nor do individuals who are chosen to participate in a trial receive equal treatment. In some trials, individuals are placed in a control group and receive a placebo from which they derive no medical benefit. The first group is then compared to the group which received the drugs, procedures, or tests under evaluation. Health Insurance Coverage Premiums for health coverage, generally paid by employers and their employees, are based upon actuarial assumptions for reimbursements or payments for a set of benefits and services that have proven effective in treating patients.
Insurers cover services that are safe and effective for a given disease or illness.
In the past, there was little oversight of the services rendered, and little pre-authorization for care. Managed Care Over the last decade, the growth of managed care has changed where and how patients receive care. As the private health care market continues to organize care systems for patients in networks or other integrated health care systems, there has been criticism that managed care reduces funds flowing into academic medical centers and other facilities that have research as one of their primary missions. Many academic medical centers in particular have had to focus on new revenue streams in addition to their medical research functions as funding from various sources has been reduced. Medicare has also made changes in its payment methodologies to certain institutions or providers.