Novel Technologies Medicare Coverage is Slow and Lacking, Say Stanford Researchers

Only 28 out of 64 medical device and diagnostic technologies, or 44 percent, requiring new Medicare coverage received reimbursement from 2016 to 2019, with the median time to at least nominal coverage taking 5.7 years, according to Stanford University researchers.

The researchers, who published their findings Friday in JAMA Health Forum, argue that such lengthy timelines to establish Medicare coverage warrant attention while the results can be used to inform new policy strategies targeting faster reimbursement.

Though achieving FDA authorization to sell a medical device permits manufacturers legal market access, actual patient uptake of these technologies is dependent on health insurance reimbursement. In particular, decisions made by CMS play a key role because they often occur before private health plans.

Read the JAMA Health Forum article here.

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