title: Cost-effectiveness and coverage policy.
abstract: Cost-effectiveness analyses have become a pervasive element of health care. But they have not had a major impact on medical coverage policy. The challenge of implementing cost-effectiveness as a medical coverage criterion is related to the following issues: (1) Contract language does not include cost-effectiveness as a coverage criterion; (2) cost-effectiveness analyses often take the societal, population-based perspective, while health care is delivered on an individual basis; (3) there is no standard methodology for cost-effective analysis; (4) there is no explicit cut-off between cost-effective and cost-ineffective; and (5) cost-effectiveness analyses are not time sensitive.
authors.forename: E
authors.initials: E
authors.lastname: Brown
authors.forename: K
authors.initials: K
authors.lastname: Fitzner
mesh_terms: D018672:Community Health Planning / Q000191:economics; D003284:Contract Services / Q000191:economics; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D019458:Insurance Coverage; D007348:Insurance, Health / Q000191:economics*; D014481:United States