How We’re Funded
PCORI is funded through the Patient-Centered Outcomes Research Trust Fund (PCORTF), which was authorized by Congress as part of the Patient Protection and Affordable Care Act of 2010 and receives income from two funding streams: the general fund of the Treasury and a small fee assessed on Medicare, private health insurance and self-insured plans. PCORI is expected to receive an estimated $3.5 billion from the PCOR Trust Fund to fund patient-centered outcomes research through September 30, 2019, the date through which the Act authorizes the fund to remain in operation.
- For government fiscal years (FYs) 2010–2012, the PCORTF received $210 million total in appropriations from general fund revenues.
- For FY 2010, $10 million
- For FY 2011, $50 million
- For FY 2012, $150 million
- For FY 2013, the PCORTF will receive $150 million from the general fund in appropriation plus an annual $1 fee per individual assessed on Medicare and private health insurance and self-insured plans. The combined estimated total is $320 million.
- For FYs 2014-2019, the PCORTF will receive $150 million from the general fund in appropriation plus an annual $2 fee per individual assessed on Medicare and private health insurance and self-insured plans and an adjustment for increase in healthcare spending. The combined estimated total averages $650 million per year.
Each year, 20 percent of PCORTF funding is directed by the law to be transferred to the Department of Health and Human Services to support dissemination and research capacity-building efforts. Eighty percent of that amount is transferred to the Agency for Healthcare Research and Quality for these purposes.
Additional details on how PCORI is funded are provided in the authorizing law in Sec. 1183 and Sec. 9511, beginning on page 15 of this PDF.
The deadline for collection of the PCORTF fee by the Internal Revenue Service for the first time was July 31, 2013. PCORI does not establish, collect or otherwise administer the fee. All questions about this fee should be referred to the IRS. The final regulations addressing the fee provide this IRS contact information:
· For self-insured health arrangements: Lisa Mojiri-Azad at 202-622-6080
· For health insurance policies (fully insured): Rebecca L. Baxter at 202-622-3970
You may also wish to visit the section of the IRS website that contains guidance and regulations related to the Patient Protection and Affordable Care Act. The website, under the heading “Patient-Centered Outcomes Research Institute,” also includes the following resources: Questions and Answers; Summary Chart; Final Regulations. The IRS has released a revised version of Form 720 that includes two new lines for the PCORTF fee (one line for plan sponsors of self-insured plans and one line for health insurance issuers).