A State Collaboration: Incorporating Evidence into Medicaid Decision-Making

The Medicaid Evidence-Based Decisions Project (MED) is a new collaborative initiative intended to help states make sound decisions about Medicaid coverage and benefits based on evidence of effectiveness and safety. The project offers participating states access to:

• systematic reviews of evidence on effectiveness of health care treatments and equipment;
• assessments of existing and emerging health technologies;
• a Web-based clearinghouse and communications tool that enables states to share information about relevant developments;
• support in designing rapid evaluations of medical products; and
• consultations with research staff to help members apply the evidence to their state's needs.

"MED will allow states to gain maximum value for their Medicaid dollars by limiting spending for ineffective and marginal services and maximizing their use of services and products that actually result in significant health gain," according to Kathleen Cota, director of health services and medical management in Minnesota's Department of Human Services.

The MED initiative is coordinated by the Center for Evidence-Based Policy in the Department of Public Health and Preventive Medicine at Oregon Health and Science University. It builds on the Drug Effectiveness Review Project, a collaborative effort that provides participating states and others with objective effectiveness comparisons between drugs in the same class and assistance in applying that evidence to purchasing and management decisions.

MED creates a research pool, enabling participating states to combine resources to commission critical research that can be used in Medicaid (and other state health program) purchasing and coverage decisions. The initiative provides states with evidence-based responses to pressure from vendors and advocates to provide services that are not clearly demonstrated to be beneficial. The Center for Evidence-Based Policy negotiates with research entities to conduct the reviews and assessments, coordinates their efforts, and ensures the quality of the research.

Since the launch of MED, in January 2006, 10 states have either joined the initiative or are in contract discussions, and several more have expressed interest. Membership costs $158,000 per year over the initial two years of the project. The collaboration is self-governing and the participating states will decide whether the information will be circulated outside of the member group.

For More Information Contact: Mark Gibson, Deputy Director, Center for Evidence-Based Policy, Oregon Health and Science University, [email protected] Visit: Medicaid Evidence-Based Decisions Project Site