The Health Evidence Review Commission reviews clinical evidence in order to guide the Oregon Health Authority in making benefit-related decisions for its health plans. Its main products are the Prioritized List of Health Services (searchable tool), used by the legislature to guide funding decisions for the Oregon Health Plan (Medicaid), and evidence-based reports on specific topics of interest to Oregon health payers and providers as well as members of the public.
The Commission consists of 13 Governor-appointed and senate-confirmed volunteer members including five physician representatives (one of whom must be a doctor of osteopathy and another a hospital representative), a dentist, a public health nurse, a behavioral health representative, a provider of complementary and alternative medicine, a retail pharmacist, an insurance industry representative and two consumer representatives.
When the HERC was created during the 2011 Legislative session, it combined two previously existing commissions, the Health Services Commission and Health Resources Commission. HERC continues two decades of work, as both of the original commissions began their work in the early 1990s at the start of the Oregon Health Plan.
Charge to the Commission
The Health Evidence Review Commission (HERC) shall:
- Develop and maintain a list of health services ranked by priority, from the most important to the least important, representing the comparative benefits of each service to the population to be served
- Develop or identify and shall disseminate evidence-based health care guidelines for use by providers, consumers and purchasers of health care in Oregon
- Conduct comparative effectiveness research of health technologies
Methodology and Standards:
A Brief History of Health Services Prioritization in Oregon
Aware of the need for accountable and effective funding of health care, Oregon established a set of policy objectives to guide the development of a methodology for setting health care priorities. In 1989, the Oregon Legislature created the Health Services Commission and directed it to develop a prioritized list of health services ranked in order of importance to the entire population to be covered. The Commission first tested a formulaic approach using a cost/utility analysis, but the results were unsatisfactory. Subsequent successful approaches rank- order general categories of health services (e.g., Maternity and newborn care; Comfort care) based on relative importance as gauged by public input and on Commissioner judgment. Within these general categories, individual condition/treatment pairs are prioritized according to impact on health, effectiveness and (as a tie-breaker) cost. The resulting prioritized list is used by the Legislature to allocate funding for Medicaid and SCHIP, but the Legislature cannot change the priorities set by the independent Commission. The benefits based on the prioritized list are administered primarily through managed care plans, and approximately 1.5 million Oregonians have gained health coverage due to the expanded access made possible by explicitly prioritizing health services.
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