Thursday, June 4, 2009

How to Use Comparative Research to Manage Health Care Costs

Recent proposals from the American Medical Association (AMA) to voluntarily use comparative research information ring hollow without their having any teeth to assure the information is in fact used.

I thought Gail Wilensky had some thoughtful comments on the issue of using comparative research to control health care costs in today's Kaiser Health News.

An excerpt from her interview with Christopher Weaver:
Q: Last summer, you wrote… that it's "vitally important to keep comparative clinical effectiveness analysis and cost-effectiveness analysis separate from each other." Can you tell us a little more about what that means?

I believe that the information from comparative clinical effectiveness needs to be paired with financial incentives to encourage their more appropriate use... What that means is that when there is good clinical evidence… for treating a particular type of cardiac disease or orthopedic disease or whatever, you ought to have the lowest copayments… and higher copayments when the likelihood (of a positive outcome) is very uncertain or very low.

You've already seen people who are raising the flag of rationing, (saying the research is) just a backdoor way to deny effective care because you don't want to pay for it. I don't want to arm those critics.

Q: What about the suggestion by Sen. Jon Kyl, R-Ariz., that this research could "deny or delay health care for Americans"?

A: Many things could deny and delay health care for Americans if they're enacted inappropriately. In a country where your likelihood of getting what's clinically appropriate is 53 percent, it's not a very useful threat.
Read the entire interview here.

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