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About the Program
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Purpose

The primary purpose of HTA is to ensure medical treatments and services paid for with state health care dollars are safe and proven to work. HTA serves as a resource for state agencies purchasing health care. HTA contracts for scientific, evidence-based reports about whether certain medical devices, procedures, and tests are safe and work as promoted. An independent clinical committee of health care practitioners then uses the reports to determine if programs should pay for the medical device, procedure, or test.

Participating state agencies include the Health Care Authority; Department of Social and Health Services (Medicaid); Labor and Industries; Department of Corrections; and Department of Veterans Affairs. State agencies using the same, evidence-based reports make more informed and consistent coverage decisions.

Mandate

  • Promote excellent health care by investigating what works.
  • Contract for impartial, peer reviewed evidence-based reports to support better decision making.
  • Use the expertise of an independent committee of practicing health care providers to review the reports and make health care coverage decisions.
  • Maintain an open process for nominations of health technologies and information gathering about selected technologies.
  • Support a centralized location for state agencies to share information on other health care coverage decisions.
  • Select six technologies in the first year and eight technologies in the second year for study and coverage decision.

Background / Problem Statement

New innovations in medicine, even in the last ten years, have improved the health and lives of patients, yet they have come at a high cost in terms of health, safety, and affordability. Health care spending and costs are rising dramatically, but patients in the U.S. are not getting healthier nor using health care that is available, recommended, and proven to work. Medical products and treatments are introduced without independent, scientific evidence about whether they are safe, effective, and provide benefits that are better than existing alternatives. The information age has compounded the problem – there is a flood of information, but doctors and patients don’t have the tolls or the time to sort through it all.

This overload of information, combined with a lack of tools to understand or test the information’s reliability has led many health care professionals to turn to evidence-based medicine to identify best practices in treatment and diagnosis as well as payment and coverage decisions.

HTA is leading the state effort to use evidence-based medicine to make health policy and coverage decisions. HTA expects the following benefits when using information based on science to make decisions about health care coverage:

  • Better health - Washington patients and providers have access to a centralized place to learn about proven health care.
  • Transparency - the technology selection, evaluation, and committee decisions follows a published process and are open to public input.
  • Eliminates bias - neither the state agency payer nor a company selling products makes the decision, but all can provide information.
  • Consistency - state agencies will be relying on a single, scientifically based source, to inform coverage decisions on the selected technologies.
  • Evolving and flexible - technical innovations occur regularly, and evidence-based reports are also reviewed regularly to ensure that the latest information has been considered.

How Technologies are selected for Review

Because of the length of the process, only a limited number of health technologies, fourteen in the first two years, will undergo this rigorous process. The medical devices, procedures, and diagnostic tests are selected based on concerns about whether the technology is safe, whether it works as intended, and whether it is cost-effective, especially when compared to alternatives or where there is a variation in how it is used. State agency physicians identify potential health technologies of concern. These topics are prioritized based on legislative requirements and criteria widely used in technology assessment priority setting. Agency recommendations are sent to the Administrator for selection. The public will also be able to petition for a technology to be reviewed, and the same criteria will be applied.

Documents

Next Steps

These technology topics will be posted for thirty (30) days to gather public comment. An impartial research firm, called a Technology Assessment Center, will then conduct a review of the evidence about safety, effectiveness, and cost comparisons and write a report that summarizes the evidence and the methods used to analyze it. These assessment reports typically take between two and six months to complete. Once the report has been completed, it is given to the Health Technology Clinical Committee. The clinicians on the committee will use the evidence report to decide whether the technology is shown to be safe and effective; whether Washington state agencies will pay for the technology; and under what circumstances. The initial review and decision process will take between six and twelve months, and technologies will be considered for re-review at least every eighteen months.

Key Terms

Health Technology is a broad term that includes: medical / surgical devices and procedures; medical equipment; and diagnostic tests. Health technologies range from simple items to complex tools or treatments, such as:

  • Eye glasses or oxygen tanks
  • Magnetic Resonance Imaging (MRI)
  • Stereotactic Radiosurgery (SRS), "Gamma knife surgery"
  • Acupuncture

Health technology does not include prescription drugs. For more information on prescription drug purchasing, see Health Care Authority's Prescription Drug Program.

A health technology assessment is a study performed by researchers, generally individuals that have a clinical background and are trained in research methods. The assessment includes a systematic review of scientific evidence about the selected health technology. Evidence about a technology could include clinical trials, case studies, published research, and other materials. The assessment results in a conclusion or rating about whether, and to what extent, the scientific evidence demonstrates that the health technology is safe, works as intended, and is cost effective. Health technology reviews can be conducted for new and emerging technologies or for existing technologies that are used in new ways or where new information becomes available.

The Health Technology Clinical Committee is an independent group of eleven practicing physicians and other health care providers. The committee uses the evidence-based reports to make medical coverage decisions that apply to the participating state agencies.