[How much knowledge do health insurance companies need to make reimbursement decisions?].
Health insurance companies play a very significant role in the sociopolitical context. It is their responsibility to meet the demands of modern health services delivery, while at the same time limited financial resources need to be considered. Difficult decisions have to be made which must take into account the needs of the insured party as well as the healthcare situation and oncoming possibilities. Health insurance companies rely on secure knowledge with a high level of evidence to justify their decisions in a collectively funded healthcare system. Where the elimination of knowledge gaps is not related to the expectation of profit on the part of potential providers of medical services, procedures or products the funding of high-quality studies should be considered.
Pfeiffer
Doris
D
Spitzenverband Bund der Krankenkassen, Berlin. Doris.Pfeiffer@gkv-spitzenverband.de
D003657:Decision Making; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000592:standards*; D019359:Knowledge; D011785:Quality Assurance, Health Care