Coverage of Laser Technology by Health Insurers.
Abstract
New medical technologies hold both the promise of significant health benefits and the prospect of additional health care spending. Private health insurance companies-through which most health care is paid for-shoulder a considerable responsibility in deciding which new technologies will be covered by insurance, and when in the cycle of development the time arrives to approve coverage. In general, insurance coverage is denied for technologies that are considered unproved or experimental. Despite the obvious importance of these decisions, relatively little systematic information is available about the procedures that insurers go through and the criteria they use to weigh the evidence. This background paper presents some empirical information on how insurers consider payment for new medical devices. It describes the survey results of medical directors affiliated with private health insurers about their coverage decisions using, as examples, three applications of lasers: laser angioplasty for opening narrowed or blocked coronary arteries; laser discectomy for treating herniated intervertebral discs; and photodynamic therapy (using a light-sensitive dye) for bladder cancer.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 1995
- Accession Number
- ADA336983