Applied Policy Projects
CMTP engages in a range of activities related to the use of evidence in health and clinical policy decision making. These activities, from pilot projects to policy analyses, often focus on new and innovative solutions for incorporating comparative effectiveness research into policy and practice. Our projects in the Applied Policy and Methods arena aim to address the question, “What practical tools, policy mechanisms or strategies can be used to circumvent barriers to implementing the types of studies that decision makers need?”
Coverage with Evidence Development
We have also been exploring ways in which we can create a more conducive environment for public and private health plans to support Coverage with Evidence Development (CED), a policy tool that allows them to offer conditional coverage for promising new technologies while additional data are being generated to understand the technology’s relative benefits and safety. Early in 2009, CMTP staff participated in a summit on CED where individuals with experience in implementing these studies from around the world shared their successes and failures and insights into ways to improve CED projects in the future. CMTP’s views about the US experience have been incorporated into a collection of papers that will be published early in 2010 (Mohr and Tunis, forthcoming).
CED Private Sector Pilot
With funding from the California HealthCare Foundation, CMTP is conducting a private sector pilot CED project. This 18-month endeavor, which began in February of 2009, has engaged a multi-stakeholder work group to lay the foundation for a CED study on the use of pharmacogenetic testing for warfarin dose response. Read more...
Model Benefit Language
Extending CED beyond the Medicare population has great appeal as a creative approach to encourage decision-maker-oriented research into important—but inadequately proven—emerging technologies. Several obstacles currently stand in the way of this approach, however. CMTP partnered with a group of health plans, patients, physicians, employers and policy leaders to develop a conceptual framework that addresses these obstacles
Comparative Effectiveness Research Policy Reports
CMTP occasionally conducts policy analyses for various entities in the clinical and health policy arena. These reports build on CMTP's expertise in comparative effectiveness research and related policy initiatives.
The Use of Comparative Effectiveness Research and Coverage with Evidence Development in the Medicare Program
For MedPAC, CMTP completed review of the CER landscape and the potential for expanded use of CER findings in payment and coding policy within Medicare, as well as the potential direction of CED policies within the Medicare program. This project will culminate in the delivery of a white paper and a presentation of key findings to the MedPAC commissioners in early 2010. According to MedPAC officials, this project fits into the commissioners’ overarching focus on methods for improving the institutional capacity of CMS to implement evidence-based policy.
An International Case Study: Comparative Effectiveness Research in Ontario Canada
CMTP completed a case study for the Institute of Medicine (IOM) that describes the network of programs in place in Ontario, Canada to carry out comparative effectiveness research studies. These studies address questions posed by health care decision-makers concerning emerging technologies and promote evidence-based technology diffusion. In the United States, the growing demand for information to support evidence-based decision-making has created a need for the design and implementation of a system of prospective evidence generation aimed at addressing evidence gaps of importance to the health care community. Although the United States health care system differs from Ontario’s in size, complexity, and design, Ontario’s experiences provide important insights into the workforce, organization, and funding required to build a capacity to conduct comparative effectiveness in the United States. This issue brief presents an overview of the efforts in Ontario followed by several policy recommendations for creating an infrastructure and assuring funding of comparative effectiveness in the United States.
