Htalogo
Washington State Clinicians make a draft decision on Applied Behavioral Analysis Therapy
 Print  Email Share Bookmark & Share

For Immediate Release: 06/28/2011
Contact: Doug Porter, Director, Health Care Authority, 360-725-1040
Richard Onizuka, Director of Health Policy, HCA, 360-923-2820
Leah Hole-Curry, Director, Health Technology Assessment Program, HCA, 360-923-2748

OLYMPIA-The Health Technology Clinical Committee (HTCC), a group of local, practicing clinicians has completed a key step-a draft coverage vote-in a two-year process to evaluate Applied Behavioral Analysis (ABA) Therapy for treatment of Autism Spectrum Disorder. The committee made the decision at its quarterly meeting on June 17. ABA is a learning theory-based technique that many treatment programs are based on to address cognitive and behavioral deficits by behavior modification and repetition.

The thorough process is used for important decisions about whether state agencies should pay for certain medical tests or treatments when questions remain about whether the test or treatment is proven safe, effective, and cost-effective. For ABA, the HTA program worked with a national program to ensure that the evidence report was comprehensive: medical evidence on ABA was searched, summarized, and graded, and comments from both national and local experts, specialty societies, and the public were sought, collected, and incorporated.

At its public meeting, the HTCC reviewed and discussed the comprehensive evidence report and comments from stakeholders. Six programs that are based on ABA had clinical evidence, though for most programs the evidence was insufficient; there was low evidence for two of the six programs. The HTCC voted 7 to 2 that, overall, behavioral interventions using ABA for treatment of Autism are unproven.

However, two interventions that are the most studied, while there is still very low quality evidence, show that some improvements may result for some children. Thus, the HTCC's draft decision is that state agencies should cover, in a trial setting only, those two ABA therapy interventions so that more reliable evidence on important health outcomes is generated. More specifics about the criteria for the research are expected with the final decision, due to be adopted at the next HTCC meeting on September 16, 2011.

Committee's decisions are published on the internet (www.hta.hca.wa.gov) by the Health Technology Assessment program for public comment after the meeting record is transcribed. The draft decision of the June 17 meeting is expected to be posted by July 11 and will be open for a two-week public comment period.

The Health Technology Assessment committee is an independent panel of 11 practicing health care professionals who make coverage decisions for state-funded programs. Using independent clinical evidence, the HTCC determines if certain procedures or technologies are safe, effective, and cost-effective.

The committee's decisions are used to determine whether the procedures will be covered under public-funded health coverage in Medicaid, state employee health benefits, worker compensation or other state-purchased health care.

Health Technology Assessment Program Director Leah Hole-Curry said the program was created by the Legislature to make decisions about paying for medical care that is proven safe, effective, and has value. As much as one-third of the nation's total health care spending currently goes toward treatments that do not work.

"We need to spend state resources wisely on quality care found by using independent reports and unbiased, local clinicians in a public process," she said.

Since 2007, the program's committee has finalized 23 coverage decisions:

  • The committee recommended against coverage of 10 of the technologies after finding that evidence showed the technology did not work or that evidence does not yet show net health benefits.
  • Thirteen other technologies were recommended for coverage under certain conditions where evidence demonstrated benefit.

Overall, the committee's work is saving the state more than $31 million annually in cost avoidance for unproven, ineffective, or unsafe medical care since its creation by the Legislature in 2007.

FOR ADDITIONAL BACKGROUND: