Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-08T07:20:50.009Z Has data issue: false hasContentIssue false

The Use of Technology Assessment by Hospitals, Health Maintenance Organizations, and Third-Party Payers in the United States

Published online by Cambridge University Press:  10 March 2009

Bryan R. Luce
Affiliation:
Battelle Medical Technology Assessment and Policy (MEDTAP) Program
Ruth E. Brown
Affiliation:
Battelle Medical Technology Assessment and Policy (MEDTAP) Program

Abstract

A case study design was used to determine the reliance on technology assessment of decisionmakers in hospitals, health maintenance organizations (HMOs), and third-party payers. Thirty different organizations were contacted and semistructured interviews conducted. The study found that hospitals, HMOs, and insurers are conducting technology assessments, but the form and sophistication of these analyses range widely. Hospitals are particularly focused on traditional financial analyses (“prudent purchasing”) with the exception of pharmacy committees, which generally conduct more sophisticated socio-economic analyses. HMOs and insurers conduct outcome assessments for coverage of expensive or controversial technologies but exclude economics. Technology assessment will become increasingly important in resource allocation decision making and it is in the interest of technology providers to foster better information, a more comprehensive assessment process, and a more efficient assessment system.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Banta, H. D., & Luce, B. R.Health care technology and its assessment: An international perspective. Oxford: Oxford University Press, 1993.CrossRefGoogle Scholar
2.Banta, H. D., & Thacker, S. B.The case for reassessment of health care technology: Once is not enough. Journal of the American Medical Association, 1990, 264, 235–40.CrossRefGoogle ScholarPubMed
3.Drummond, M., Brandt, A., Luce, B. R., & Rovira, J.Standardizing economic evaluation methodologies in health care. International Journal of Technology Assessment in Health Care, 1993, 9, 2636.CrossRefGoogle ScholarPubMed
4.Elixhauser, A., Luce, B. R., Taylor, W., & Reblando, J.Cost benefit and cost effectiveness analyses from 1979 to 1990: A bibliography. Medical Care 1993, 31(5), 1149.Google Scholar
5.Federal Register, Vol. 54, No. 18, 01 30, 1989.Google Scholar
6.Fowler, J. R. Jr., Wennberg, J. E., Timothy, R. P., Barry, M. J., Mulley, A. G. Jr., & Hanley, D.Symptom status and quality of life following prostatectomy. Journal of the American Medical Association, 1988, 259, 3018–22.CrossRefGoogle ScholarPubMed
7.Fox, D. M., & Leichter, H. M.Rationing care in Oregon: The new accountability. Health Affairs, 1991, 10, 727.CrossRefGoogle ScholarPubMed
8.Fuchs, V. R., & Garber, A. M.The new technology assessment. New England Journal of Medicine, 1990, 323, 673–77.CrossRefGoogle ScholarPubMed
9. Guidelines for preparation of economic analysis to be included in submission to Drug Program Branch for listing in the Ontario Drugs Benefit Formulary Comparative Drug Index, Ontario, Canada, draft, 1991.Google Scholar
10.Henry, D.Economic analysis as an aid to subsidization: The development of Australian guidelines for Pharmaceuticals. PharmacoEconomics 1992, 1, 5467.CrossRefGoogle Scholar
11.Institute of Medicine. Setting priorities for health technology assessment: A model process. Washington, D.C.: National Academy Press, 1992.Google Scholar
12.Luce, B. R.Cost effectiveness analysis — Obstacles to standardization and its use in regulating Pharmaceuticals. Pharmaco Economics, 1993, 3, 19.CrossRefGoogle ScholarPubMed
13.McGivney, W. T.High dose chemotherapy: Autologous bone marrow transplantation — A model for health care decision making? Presented at Institute of Medicine Conference, Examining Coverage and Adoption Decisions About Medical Technologies,Washington, D.C. 1992.Google Scholar
14.McNeil, B. J., Weichselbaum, R., & Pauker, S. G.Fallacy of the five-year survival in lung cancer. New England Journal of Medicine, 1988, 299, 1397–401.CrossRefGoogle Scholar
15.Office of Technology Assessment, Assessing the efficacy and safety of medical technologies. Washington, DC: Office of Technology Assessment: 1978, Publication OTA-H-75.Google Scholar
16.Office of Technology Assessment. Development of medical technology: Opportunities for assessment. Washington, DC: Office of Technology Assessment. 1976, Publication OTA-H-34.Google Scholar
17.Perry, S.Technology assessment in health care: The U.S. perspective. Health Policy, 1988, 9, 317–24.CrossRefGoogle ScholarPubMed
18.Rettig, R. A.Technology assessment — An update. Investigative Radiology, 1991, 27, 165–73.CrossRefGoogle Scholar
19.Roper, W. L., Winkenwerder, W., Hackbarth, G. M., & Krakauer, H.Effectiveness in health care: An initiative to evaluate and improve medical practice. New England Journal of Medicine, 1988, 319, 1198–202.CrossRefGoogle ScholarPubMed