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Technology assessment and coverage decision making
1Aetna Health Plans, Hartford, CT, USA.
AAPPO Journal : the Journal of the American Association of Preferred Provider Organizations
|August 6, 1994
Summary
Technology assessment provides crucial initial evaluations for healthcare decisions, impacting coverage and guidelines. A scientific process ensures defensible judgments for effective patient care and managed care implementation.
Area of Science:
- Health Services Research
- Medical Technology Assessment
- Health Policy
Background:
- Technology assessment is the initial step in healthcare decision-making, influencing coverage, clinical guidelines, and utilization.
- Its significant impact necessitates a scientifically sound and defensible assessment process.
Purpose of the Study:
- To outline the essential components of a scientific and defensible technology assessment process.
- To ensure that technology assessment facilitates and substantiates medical and coverage decisions.
- To support the implementation of outcomes-based decision-making in managed care.
Main Methods:
- Defining four core components for a scientific technology assessment process.
- Emphasizing the use of controlled clinical trials for outcomes data.
- Highlighting the importance of medical community acceptance and rigorous analysis.
Main Results:
- A scientific process requires reliable outcomes data, evidence of clinical acceptance, rigorous analysis, and consistent terminology.
- Such a process ensures methodological defensibility and supports informed decision-making.
- It facilitates the integration of managed care principles focused on outcomes.
Conclusions:
- A robust technology assessment framework is vital for evidence-based healthcare decisions.
- The outlined components provide a foundation for scientifically defensible technology evaluation.
- Implementing this process enhances the efficiency and effectiveness of managed care.
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