The AAN's role in the development of health insurer coverage policy

Abstract

Scientific, evidence-based clinical practice guidelines (CPGs) differ from coverage/policy statements. The latter incorporate values and priorities and translate evidence into human benefit. They assist provider and payer decisions, and abide by extant laws and regulations. Payers have set internal processes for balancing and integrating the intent of CPGs into their coverage/payment policies. Recently, however, their efforts to reach out to respected medical specialty societies for input are increasing. In response, the American Academy of Neurology (AAN) has taken the following steps: 1) it is reacting to, and providing input to, payer requests for policy reviews; 2) it is taking a proactive approach by developing AAN guideline companion documents that describe potential provider impacts and policy implications; and 3) it is commencing an initiative to write its own template policies. This new involvement has met with initial positive outcomes. The AAN will continue to expand efforts to fulfill a growing need in this area. Copyright © by AAN Enterprises, Inc.