TABLE 3-1 Context for Setting Priorities for Evidence Assessment, 2006

Organization

Target Audience

Number of Full Systematic Reviews

AHRQ

 

 

Effective Heath Care Program

CMS, providers, policy makers, consumers

4

EPC program

CMS, USPSTF, NIH, and other federal agencies; providers; medical professional societies

22

USPSTF

Primary care clinicians, health systems, payers, and purchasers

6

Other federal programs

 

 

CMS

Medicare intermediaries, beneficiaries, and providers

9

DERP

State Medicaid programs

3

NIH Consensus Development Program

Health professionals and the public

3

Private technology assessors

 

 

BCBSA TEC

Medical directors of BCBSA member plans, providers, and scientific staff

14

ECRI Institute

Private clients, including decision makers in hospitals, health systems, health plans, and departments and ministries of health

20

Hayes, Inc.

Private clients, including decision makers in hospitals, health systems, health plans, and government agencies

86

NOTE: DERP = Drug Effectiveness Review Project; USPSTF = U.S. Preventive Services Task Force.

SOURCES: AHRQ (2007c,d,e); BCBSA TEC (2007); NIH Consensus Development Program (2007).

the Centers for Medicare & Medicaid Services (CMS) on the services used by the Medicare population, sponsors evidence reviews (conducted by an AHRQ EPC) only when Medicare is considering a national coverage decision on a controversial issue.

In general, payers initiate assessments when they must make benefits and coverage decisions about new technologies or new applications of existing technologies. In this context, the decision usually involves a categorical



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement