title: Pre-coverage assessments of new hospital interventions on Austria: methodology and 3 years of experience.
abstract: OBJECTIVE
  A new decision-making process was set up by the Austrian Ministry of Health to regulate coverage of new proposed Extra Medical Services (EMS; German: Medizinische Einzel-Leistung [MEL]) in 2008. As part of the annual decision-making process an independent academic institution (LBI-HTA) is evaluating relevant evidence on these new technologies and provides HTAs, including evidence-based recommendations for decision makers.
  
  
  METHODS
  About ten EMS assessments are performed annually by the LBI-HTA simultaneously between January and March. Each peer-reviewed report consists of a systematic literature review and critical appraisal of evidence using the GRADE methodology. The generation of numerous reports of good quality standards within the short timeframe is achieved by a standardized workflow with predefined assignment of tasks for all participants.
  
  
  RESULTS
  In total, the LBI-HTA performed twenty-five EMS assessments on thirty-three different interventions in the last three years. Coverage was recommended with limitation for eleven (33%) interventions, and not recommended for twenty-two (66%) interventions. The federal health commission decided on acceptance or preliminary acceptance of coverage in seven (22%) cases, rejection in eighteen (55%) cases and changed the status to "subject to approval" in seven (24%) cases.
  
  
  CONCLUSIONS
  Pre-coverage assessment of new hospital interventions was implemented successfully in Austria. It has proved to be a useful tool to support decision makers with objective evidence when deciding whether or not to reimburse medical services.
authors.affiliation: Ludwig Boltzmann Institute for Health Technology Assessment, Vienna Austria. philipp.mad@hta.lbg.ac.at
authors.forename: Philipp
authors.initials: P
authors.lastname: Mad
authors.forename: Sabine
authors.initials: S
authors.lastname: Geiger-Gritsch
authors.forename: Gerda
authors.initials: G
authors.lastname: Hinterreiter
authors.forename: Stefan
authors.initials: S
authors.lastname: Mathis-Edenhofer
authors.forename: Claudia
authors.initials: C
authors.lastname: Wild
mesh_terms: D001317:Austria; D003657:Decision Making; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D015397:Program Evaluation / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D013673:Technology Assessment, Biomedical / Q000379:methods*; D013997:Time Factors