The Use of Health Technology Assessment to Inform the Value of Provider Fees: Current Challenges and Future Oportunities – Canadian Health Services Research Foundation – 18 October 2011

Posted on November 1, 2011. Filed under: Health Economics, Health Technology Assessment | Tags: |

The Use of Health Technology Assessment to Inform the Value of Provider Fees: Current Challenges and Future Oportunities – Canadian Health Services Research Foundation – 18 October 2011

Don Husereau, Chris G. Cameron

“Health technology assessment (HTA) is becoming an increasingly prominent policy tool in response to concerns about rising healthcare costs driven by the use of technology. HTA is a multi-disciplinary process of policy analysis that aims to bridge the world of research with the world of decision-making by examining the medical, economic, social and ethical implications of the use of a health technology and their associated interventions. HTA seeks to define and measure (i.e., capture) the value of new products and services. It is currently being used in Canadian hospitals to decide what technologies to adopt and by some health jurisdictions to decide whether to create new provider fee codes. However, decisions to adopt a new technology are also driven by the need to provide consumer choice, provider autonomy, and patient access, underlying the principles of Canada’s Health Act. Additionally, not funding a new technology may provide disincentives to service providers to practice in health systems where services are not reimbursed, threatening the ability of the health system to reliably provide care and leading to additional costs if specialty services are not available. This, in turn, may harm the relationship between payers and providers.

In Canada, new codes for provider fees are developed in each jurisdiction using separate approaches and with very little coordination. This makes the Canadian health system susceptible to perceived inequities across jurisdictions and can lead to the phenomenon known as “whipsawing”—pressure to fund a service in other jurisdictions if only one province or territory is funding the service. There may also be pressure to pay the same amount of money for similar services without considering the social and economic context in which it will be delivered. This can result in unnecessary growth in health system costs.

The prices of new provider fees in Canada are largely based on costs to deliver the service and do not consider the relative value-for-money of the new service. This approach means providers have little incentive to perform high-value services compared to low-value services. HTA can play an important role in linking the price of a provider fee with a tangible value. This means that service prices can be modified upward for high-value services and downward for low-value services, averting unnecessary growth in health system costs.” 

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