By NextBestFitPhase 1: Enactment & build · Step 1.10
Create the Health Technology Assessment Institute
Months 0–18; continuous · HTA Institute (independent, within HHS)Discuss this step
Pros & cons of this step
Pros
- +Spending follows evidence rather than marketing.
- +Provisional coverage avoids access delays during review.
Cons
- −'Death panel' politics: coverage denials of expensive treatments are politically explosive.
- −Assessments can lag behind clinical practice.
- Rigor vs. speed: thorough assessment delays some innovations; provisional coverage speeds access but makes later removal politically hard.
Trade-off behind each system change
- Prior authorization & utilization managementLess burden; less case-by-case policing of low-value care.
- AHRQ & PCORI (comparative-effectiveness research)Research gains direct influence on coverage; research independence may suffer when findings carry coverage stakes.