A new study by the Employee Benefit Research Institute analyzes whether evidence-based clinical information can be used to discourage services and costs that do not result in improved health outcomes. (To download the study, click here.) The study cites Oregon health plans that evaluate medical evidence when deciding what treatments will be covered for Medicaid patients, an approach has been profitable for the plans. And although past efforts to use evidence-based medicine haven’t been particularly successful, say the study’s authors, obstacles such as a perceived lack of sufficient medical evidence, credibility and transparency issues, and administrative costs, can be overcome. The study concludes: “Using the best evidence for treatment and insurance coverage more strategically offers decision makers the opportunity to make more defensible decisions about what services to cover in explicit settings.”
