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Evidence-based Benefit Design Committee
Mission & Objectives
The Evidence-Based Benefit Design Committee seeks to promote value in health benefit plan design by identifying opportunities to incorporate evidence-based guidelines into coverage and programmatic decisions. The committee provides much needed guidance for self-insured employers in the era of rapid clinical innovation and progress, helping them allocate resources in accordance with latest evidence and best practices. By identifying gaps between plan coverage and medical evidence, the committee can provide guidance and recommendations for plan design, network configuration and provider and program selection. The committee also helps employers anticipate upcoming cost pressures and meet the needs of their employees. Committee members include self-insured employers and experts representing research and accreditation, as well as physicians, health plans and consumers. The Evidence-Based Benefit Design Committee seeks to promote value in health benefits plan design by:
  • Creating a forum for employers, physicians, health plans, consumers and research and policy experts to advance a new framework for health care based on medical evidence;
  • Identifying gaps between the care that the best medical evidence suggests patients should receive and what employers are incentivizing, covering, and communicating to employees in practice;
  • Translating evidence assessments into recommendations for plan design elements and employee supports to reduce misuse and overuse of health care and direct spending to high-value services;
  • Developing employee communications that encourage sound decision-making;
  • Promoting primary care and health information exchange (HIE) reforms;.
  • Enabling employers to promote shared decision-making, thereby empowering their members to become active and informed participants in their health journey;
  • Identifying quality and meaningful measures of physician performance;
  • Evaluating emerging payment models and plan design innovations aimed at improving care quality and efficiency; and
  • Reducing misuse and overuse of health care and re-directing spending toward high-value services.

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