Practical Research that Identifies and Illuminates
ACPE UAN: 0233-0000-19-033-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based
Globally, health plans and payers are expanding their efforts to solicit patient and public input when allocating health resources. However, despite the increased availability of patient-reported outcomes and consumer cost-sharing data, it is unclear how patient or health plan member input is considered by health plans when making coverage decisions. Concerns exist that patient-input may disrupt the contractual requirements for health plans to provide “medically necessary” care and treatments. Additionally, allocation of resources may be inefficient if the treatments reimbursed for care are not valued by the patients who will ultimately use the services.
This session and panel discussion will focus on the following key questions: What types of input should be considered (e.g., consultation, deliberation, etc.)? When should input be solicited (e.g., before, during or after the coverage decision)? What input should be considered (e.g., published patient-reported outcomes, lay-patients, member surveys, etc.)? Whose input matters (e.g., members, patient group, etc.)? What are the barriers and opportunities?
At the completion of this activity, participants should be able to: