Wednesday, July 22, 2015

VITAL link at Highmark

Highmark Health has started a new program to introduce innovative products to doctors and patients.  Here's the summary:

"Technologies that have received regulatory approval from the FDA often lack sufficient scientific data to convince commercial insurers to pay for them. Without support from commercial payers, it is difficult for new innovations to influence the practice of medicine.

"VITAL’s mission is to leverage Highmark Health's position as one of the largest integrated health care delivery and financing systems in the nation to accelerate the pace with which novel technologies and services are made available to our customers. In doing so:
• Members and patients will be afforded access to safe new technologies without undue financial burden.
• Payers will be able to understand the full impact of new technologies on their members without changing insurance medical policy prematurely.
• Providers will gain early access to novel technologies and a first-hand understanding of their impact on patients.
• Technology vendors will have the opportunity to prove the benefits of their new innovations to patients, providers and payers.

"The VITAL innovation program is essentially a test bed designed to facilitate early use of technologies that have received regulatory approval and are being used for their intended purpose within the approved patient population but are not yet covered by most commercial insurers. VITAL is designed to provide the missing link between FDA approval of an innovative technology and its full reimbursement."

This is interesting.  I view this program as a mechanism to moderate the tension between a desire to get new technologies out quickly and analyzing the clinical efficacy and cost effectiveness of those same technologies.  This will be a good one to watch over the coming months and years.

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