Using Evidence
Workshop Brief for State and Local Healthcare Policymakers
This workshop was designed for State and local healthcare policymakers who are interested in learning about evidence-based decisionmaking, building their capacity to evaluate evidence, and implementing disease management protocols. The workshop was held in Omaha, Nebraska, on May 8-10, 2000.
About the Workshop Sponsor.
Overview
The purpose of this workshop was to assist State and local officials in understanding the value of evidence-based decisionmaking and how evidence can be used in making coverage decisions and developing disease management protocols. Workshop sessions addressed how medical necessity is defined, the fundamentals of technology assessment, and public and private information resources for policymakers. Specifically, the meeting prepared participants to address the following types of
questions:
- What is evidence-based decisionmaking, and how can evidence be incorporated into the decision process?
- What are the implications of technology assessment and coverage decisions that are not consistent across the Nation?
- How are States defining medical necessity and determining the medical necessity of specific therapies and treatments?
- What is the impact of new technology on healthcare costs and quality for consumers, insurers, and providers?
- How do approaches to technology assessment and the coverage-decision process differ among private insurers, the Health Care Financing Administration (HCFA), the Agency for Healthcare Research and Quality (AHRQ), State Medicaid programs, and provider organizations? How might collaboration/consistency be encouraged?
- What types of disease management protocols exist and how might they be refined for implementation in specific settings (i.e., State Medicaid programs)?
- What are examples of leading Federal and State disease management initiatives and what lessons have been learned from these programs?
Participants
Workshop participants included officials responsible for healthcare coverage decisions, benefit design, and provider contracting. Among the participants were State Representatives and legislative staff, Medicaid and medical assistance administrators, employee health plan and worker's compensation benefits managers, medical directors, and pharmacy program administrators. Eighteen states were represented.
AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.
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