Ensuring adequate payment for the use of new technology.
To ensure that proper reimbursement is obtained for utilization of a new technology, providers should demonstrate to payers the long-term cost-effectiveness of the new technology. Providers need to determine the incremental costs incurred in using the technology and various payers' payment rates for such use. If preliminary analysis shows that reimbursement for the technology may be insufficient, providers then should conduct a detailed analysis of the new technology. This analysis should assemble comparative data of internal and external performance benchmarks from various sources, including state, regional, and national databases. In addition, providers should assess the long-term savings achieved by using the new technology, such as reductions in hospital readmissions and repeated procedures. Managed care payers are likely to find such data persuasive in determining whether to increase payment rates for a new device or therapy.
Kaden
R J
RJ
D015906:Angioplasty, Balloon, Coronary / Q000191:economics / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D005249:Fees and Charges; D005377:Financial Management, Hospital; D007349:Insurance, Health, Reimbursement; D017008:Negotiating; D011907:Rate Setting and Review; D015607:Stents / Q000191:economics; D013673:Technology Assessment, Biomedical / Q000191:economics*; D014481:United States