Coverage with Evidence in the Private Sector

Center for Medical Technology Policy has been working since its inception to develop a conceptual framework and implement a pilot project for coverage with evidence development (CED) among private health plans.  Working with some of the largest private payers on several specific clinical topics, we have gained considerable knowledge about the barriers to implementation of CED and the conditions that may help move this potentially useful policy tool to reality.  These lessons are discussed in the following briefing document:

Coverage with Evidence Development (CED) in the Private Sector:  Lessons in Design and Implementation, CED in the Private Sector (pdf) (489.3 kB)

Overall, we found while private health plans are not optimally prepared for implementing CED, many of the perceived barriers are not insurmountable.  There is a need for a better infrastructure to support cross-plan collaboration and the rapid and efficient identification and completion of research.

For more information on this project, contact Penny Mohr.