Wilmington, DE – July 15, 2021 – “Carelon Research has been pushing to transform healthcare industry evidentiary standards for 25 years,” said Mark Cziraky, president and co-founder of Carelon Research. “We changed the narrative of why we need real-world evidence-based research and why it matters to everyone.”
In 1996, clinical pharmacists, Mark Cziraky and Marcus Wilson, founded Carelon Research (formerly HealthCore) after realizing a need for more actionable evidence in clinical decision making in healthcare. The company was later acquired by Elevance Health (then WellPoint) in 2003. As a subsidiary of one of the largest health insurers in the United States, Carelon Research developed a rich data ecosystem and began integrating claims data with other data sources, including clinical, pharmacy, and lab data, to create a more longitudinal view of patients to better understand and improve health outcomes in Elevance Health’s membership.
Over the years, Carelon Research’s work has improved healthcare and impacted the lives of millions of people.
In 2014, the company showed that a shorter-course radiation, which is considered equally effective as conventional radiation for patients with early-stage breast cancer, continued being underutilized despite specialty societies recommending its use. Study results informed a far-reaching Elevance Health utilization management policy and subsequent program that led to increases in evidence-based practice.
In 2019, Carelon Research, in collaboration with Elevance Health and Sera Prognostics, began evaluating the effectiveness of a blood test and clinical interventions to mitigate the risk of pre-term birth – the leading cause of illness and death in newborns – and lower overall maternal and infant healthcare costs. Following this work, Elevance Health announced plans to make the test available to pregnant members as part of a multi-year contract with Sera. The insurer’s health plans cover more than 10% of US pregnancies annually.
Carelon Research has contributed to the evidence base in many areas including but not limited to oncology, maternity, immunology, and more recently, COVID-19, through real-world research designs, such as health economics and outcomes research studies, prospective clinical research, safety and epidemiology research, and pragmatic clinical trials.
More recently in November 2020, Cziraky, former vice president of scientific affairs and chief growth officer, became president of Carelon Research while Wilson, co-founder and former president of Carelon Research, became Elevance Health’s chief analytics officer, leading the Enterprise Analytics Core (EAC), a new division of Elevance Health that includes Carelon Research.
As a key member of the Elevance Health EAC, Carelon Research is helping to drive strategy and utilizing its federal and industry partnerships and research collaborations and collective expertise to enable its partners and Anthem to become greater insights-driven organizations.
“With a powerful research ecosystem of clinical and research expertise, data, and relationships, and unique alignment in the healthcare industry, Carelon Research has never been in a stronger position to optimize outcomes and turn insights into action,” said Cziraky. “I’m proud of all we’ve accomplished in 25 years, and I’m looking forward to the impact we will have on the future of healthcare.” .