Wednesday, November 29, 2023

NEJM Op Ed Tackles CMS Efforts to Modernize Coverage Policy


A policy opinion piece in the November 30, 2023 NEJM, by Kadakia et al., provides a fairly detailed overview of coverage problems at CMS, and the historically unsuccessful attempts to navigate them with either Parallel Review or with CED (Coverage with Evidence Development).  

The authors describe the Trump administration MCIT proposal, its collision (and sinking) with Biden policymakers, and the still-in-progress CMS proposal to create "TCET," temporary coverage for emerging technologies.  A table compares MCIT and TCET. (Below, click to enlarge).  

click to enlarge

While having a somewhat guarded view of TCET - it relies on CED and strongly mirrors the Parallel Review flop in terms of the proposed process - the authors seem to conclude that at least CMS is moving forward with something (TCET).   

While the citation list in their short paper is brief, I'd add they might have cited the Dartmouth/Zeitler paper last year on CED (here).

NEJM includes a 9 minute podcast interview with coauthor Robert Yeh.  Yeh is director of the Center for Outcomes at Beth Israel.

AI Corner

See AI summary of Kadakia, here.