How the insurance industry reviews new medical devices and technology for approval and reimbursement under indemnity and HMO contracts

Abstract

In the course of development of medical insurance as a product, the first policies were designed to address medical issues which, for all practical purposes, were simple in comparison to those today. In the 1940s and somewhat into the 1950s, technology did not have a tremendous impact on the cost of delivering health care. During the 1960s technology surged ahead, propelled by a great deal of grant monies, which continued to be readily obtainable into the 1970s. However, toward the middle-to-late portion of the 1970s and early 1980s this seemingly unlimited resource for funding came to an end. Insurance companies needed to change their methods of assessment of risk, and the medical profession was forced to change its methods of practicing medicine. These factors combined to contribute to the current climate, especially as it relates to the state of claims processing and reimbursement for health care technology. What the 1990s will bring, while not obvious, is still predictable based on history.<>