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Health Care Final 11-16-11 -   6.1 - Health Technology Assessments

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Health Care Final 11-16-11
Healthy State
Action Plan

6.1 - Health Technology Assessments
Is the state paying for what works?

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Data Notes
Data Source: Health Technology Assessment Program
Measure Definition: Health Technology Assessments Completed and in progress
Target Rationale: Budgetary constraints
Link to Agency Strategic Plan: Supporting coverage decisions on the basis of clinical evidence and patient choice
Relevance: Measure tracks progress toward target of completed assessments.

Notes: (optional)

Values for evidence categories are relative to alternative accepted therapies.

Also Available
Action Plan: No
Extended Analysis: Yes

 Summary Analysis

The Health Technology Assessment Program was initiated to evaluate the safety, efficiency and cost effectiveness of selected medical procedures and equipment, to provide policy guidance to coverage decisions by state agencies and illuminate best practices.

For CY 2007-2009, HTA completed 15 assessments. Evidence supported coverage under certain conditions for 8 technologies, and did not support coverage for 7 technologies; resulting in overall reduction in utilization for state health purchasing, up to $28 million per year in cost avoidance.

For CY 2010-2011 to date: HTA completed 9 assessments, some with multiple sub-parts.   Evidence supported coverage under certain conditions for 5 technologies, for 2 technologies, evidence supported coverage for a sub-group, but not all; and for 2 technologies evidence did not support coverage; resulting in overall reduction in utilization for state health purchasing in cost avoidance of $8.5 million, for a total of $36.5 million annual cost avoidance. 

For the most recent decision, ABA Therapy for Autism, the coverage determination was for coverage with evidence development, with specific research criteria language in the decision meant to ensure the quality and applicability of results.  The cost outcome of this decision is unclear, as acceptable studies have not been identified, and study design parameters of population size, duration and treatment level will determine budget impact.

Some HTA decisions have confirmed existing state policy; and some change state coverage. The evidence based and clinical panel process are valuable in supporting difficult health purchasing decision with a transparent, reasoned, evidence-based, clinician centered decision.