The goal of this project is to adapt AHRQ comparative effectiveness research evidence reviews to meet the needs of state and regional payers, thereby enhancing the application of evidence in payer policy decisions across New England (NE). An important component of this initiative will be a process for consideration and dissemination of the adapted reviews by a regional Comparative Effectiveness Council (CEC). We will assess the methods of review adaptation and the process and outcomes of the Council to assure that lessons can be widely shared from this innovative approach to enhancing payers'use of AHRQ reviews. This project aims to address an important policy problem related to the use of evidence in the health care system. AHRQ formats its reviews and summary guides following the principle that """"""""globalized"""""""" evidence should support local health care decision-making. But for state and regional payers, a gap exists between the current formats of these federal evidence products and what is needed to allow payers to apply this evidence more effectively at the local level to coverage decisions, tiered benefit designations, and efforts to reduce disparities. As the lead office for Medicaid and other health programs for Massachusetts, we know that two important adaptations to the current format could help us use AHRQ evidence reviews more effectively in policy making: 1) combine the isolated answers to key questions into a rating of comparative clinical effectiveness;and 2) include complementary evidence and a rating of comparative cost and cost-effectiveness from a regional perspective. In addition, our preliminary work with other NE states and regional payers has confirmed our belief that we need an independent body of regional clinical and methodological experts to serve as a trustworthy forum in which the adapted AHRQ reviews can be discussed, finalized, and prepared for dissemination in our communities. To this end, this project builds upon existing momentum toward the creation of a regional New England CEC, a goal that gained support from payer and purchaser representatives from all six NE states convened by the Massachusetts Secretary of Health and Human Services in Aug. 2009. We will test the following: 1) This approach will improve payers'knowledge and understanding of AHRQ evidence reviews;2) This approach will foster a higher degree of engagement among clinicians and other stakeholders in the policy process;and 3) This approach will facilitate greater use of AHRQ reviews to support a broad range of medical policies affecting Medicaid and privately insured patients across New England. Specifically, to achieve these goals, this project will aim to form an independent New England CEC;adapt AHRQ Executive Summaries for consideration and finalization by the New England CEC;disseminate adapted AHRQ Clinician/Policymaker Review Guides with final ratings of comparative clinical effectiveness and comparative value as determined by the CEC;and evaluate the impact of this regional adaptation and dissemination process.
Project Narrative AHRQ comparative effectiveness research evidence reviews can help meet the needs of state and regional payers by enhancing the application of evidence in payer policy decisions. This proposal would facilitate the dissemination of AHRQ reviews through the creation of the New England Comparative Effectiveness Council and the adaptation of AHRQ reviews by the Institute for Clinical and Economic Review.
