A conversation with the co-founders of Carelon Research (formerly HealthCore, Inc.): Mark Cziraky and Marcus Wilson

Why did you decide to leave your clinical pharmacy practice and start a research company like Carelon Research?

Wilson: Mark and I didn’t step into this space as entrepreneurs. It was much more about solving a problem. We were working together as clinical pharmacists in the early 90’s when we realized, firsthand, gaps in evidence necessary for sound clinical decision making in healthcare.

Cziraky: The clinicians we were working with didn’t have the information needed to support clinical decisions, and there was no systematic way of evaluating decisions and the outcomes, whether better or worse.

How did Carelon Research get started and were there any challenges you faced?

Wilson: When we started Carelon Research together in 1996, we started building out the tools and resources necessary to generate this kind of missing information, better known as real-world evidence. We began developing an ecosystem of data, expertise, and relationships to support the design and conduct of studies with benefit to the patient.

Cziraky: We were early pioneers in this area of research. And we knew that we were pioneers because people, data, and technology were not ready to support the cutting-edge, pragmatic designs and research that we were looking to do. The challenge was we had to convince the healthcare community — providers, payers, life sciences companies, regulators, and even patients — of the need to support the development, use, and application of the evidence generated through this research.

In 2003, Carelon Research (formerly HealthCore) chose to be acquired by Elevance Health (formerly WellPoint). How did this move into the payer world impact your goal of filling gaps in evidence?

Wilson:When we pursued the acquisition by Elevance Health, one of the largest health insurers in the country sitting on a rich data ecosystem with enormous reach and depth, our ability to connect data with the analytic and research capabilities we were building quickly moved beyond what was otherwise possible.

Cziraky:That strategic decision was an accelerant for us. It gave us several million more lives to utilize in research and set the foundation to generate insights and disseminate them to those who can benefit – pharmacy benefits managers, practitioners, members. Our multidisciplinary team of experts uniquely enabled us to not only design studies and generate insights, but also translate the value and benefit back to different healthcare stakeholders.

How has Carelon Research evolved since the acquisition? How has this evolution positioned Carelon Research to fulfill its mission more completely?

Cziraky: In 2021, Marcus became the Chief Analytics Officer at Elevance Health overseeing the development of the Enterprise Analytics Core, Carelon Research joined the Enterprise Analytics Core, and I became President of Carelon Research. This opportunity has enabled us to achieve greater alignment with Elevance Health and begin generating evidence with increasing relevance and impact on its membership. It continued to increase the potential for quicker application of the information generated and better alignment of our research designs.

Wilson: Elevance Health made a strategic decision to shift from a health benefits company to a whole health company, focused on the interactions and links between the unique facets of an individual’s health, including their physical, social, behavioral and pharmacy needs. This shift has been, and continues to be, supported by the evidence and associated opportunities that have resulted from HealthCore’s cutting-edge work by Carelon Research.

On March 1, 2023, Carelon Research has officially joined the Carelon family of companies under Elevance Health. What does this mean for Carelon Research?

Cziraky:As Carelon Research, we will continue supporting the need for evidence generation and research collaboration. Our ability to measure and improve the safety, effectiveness, and affordability of medical technologies is critical to Carelon’s mission of solving healthcare’s most complex challenges together. As part of Carelon, we will continue delivering the scientific expertise, unparalleled data, relationships, and evidence-generation capabilities long valued by our partners and clients in life sciences, government, and academia.

How does the work of Carelon Research matter to the average person?

Cziraky:If these much-needed insights are not generated, then the most informed and best healthcare decisions cannot be made about you or your family members– period. We need to continue to advance our research designs to generate the most relevant information to help you and your clinicians make the best decisions on our care.

Wilson:What gets us out of bed every morning is knowing that the problem of gaps in evidence is still unsolved. We’ve made an impact on healthcare and research, but we’re not finished yet.

Cziraky: Carelon — an organization serving 1 in 3 people in the U.S. — is committed to supporting whole health across the entire healthcare continuum. Imagine what our research can do with the backing of a mission like that... I’m proud of all that we’ve accomplished in 26 years, but I’m really looking forward to the impact we’re going to have on the future of care.