Satya-Murti Saty, Shepard Katie M
Health Policy Consultant (SS-M), Santa Maria, CA; American Academy of Neurology (KMS), Minneapolis, MN.
Neurol Clin Pract. 2012 Jun;2(2):139-145. doi: 10.1212/CPJ.0b013e31825a722b.
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.
科学的、基于证据的临床实践指南（CPG）不同于保险范围/政策声明。后者纳入了价值观和优先事项，并将证据转化为对人类的益处。它们有助于医疗服务提供者和支付方做出决策，并遵守现行法律法规。支付方已制定内部流程，以平衡CPG的意图并将其纳入保险范围/支付政策。然而，最近他们向受尊敬的医学专业协会寻求意见的努力正在增加。作为回应，美国神经病学学会（AAN）采取了以下措施：1）对支付方的政策审查请求做出回应并提供意见；2）采取积极主动的方法，制定AAN指南配套文件，描述对医疗服务提供者的潜在影响和政策含义；3）开始一项编写自己的模板政策的倡议。这种新的参与已经取得了初步的积极成果。AAN将继续扩大努力，以满足这一领域不断增长的需求。
