Title: The new realities in health care technology assessment in US institutions

Authors: Curtis P. McLaughlin, Kit N. Simpson

Addresses: Kenan-Flagler Business School, School of Public Health, Carroll Hall, CB3490, University of North Carolina, Chapel Hill, NC 27599-3490, USA. Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, NC 27599-7400, USA

Abstract: Changes in US health care financing have prompted changes in technology assessment in US health care institutions. Emphasis is shifting from capital budgeting proposals in support of revenue enhancement to marginal cost analysis in support of cost-reducing measures. This requires skills related to marginal cost finding and analysis, detailed process and activity mapping, outcome mapping, and integrative modelling. The implementation of these skills also calls for structural adjustments related to top management involvement and governance processes, multidisciplinary analysis teams, financial management outside of capital budgeting, and institutional values with respect to resource allocation, skills which many institutions currently lack. If they are not to be at the mercy of vendors and payers who are trying to specify the technologies to be used, they must be equipped to make independent judgments about efficiency, effectiveness, quality and value.

Keywords: capitation contracts; negotiated prices; diseconomy of scale; health care; technology assessment.

DOI: 10.1504/IJTM.1998.002619

International Journal of Technology Management, 1998 Vol.15 No.3/4/5, pp.507-521

Published online: 01 Aug 2003 *

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