Although the ACA sought to provide affordable health care and reduce the cost of quality care, the legislation prevents the federal government from using the cost of care, as well is information about the cost-effectiveness of care, in Medicare coverage decisions. Currently, only comparative effectiveness analysis is permitted. When determining which care should be provided, decision-makers may compare which treatment options would be most effective and cause least harm, but cost may not be a consideration. Each of the policy experts at the TMC policy forum meeting vehemently agreed that cost discussions must be part of the equation. In the United Kingdom for example, cost is a central figure for determining guidelines for care. The National Institute for Health and Care Excellence (NICE) is a non-departmental public body of the Department of Health, which publishes guidelines in four areas: the use of health technologies within the National Health Service (NHS); clinical practice; guidance for public …show more content…
One QALY is a year in perfect health and zero QALYs is death. Questionnaires are used to calculate quality of life in between based on mobility, everyday activities, self-care, pain, and mood. If a new treatment is cheaper than current practice with similar or better outcomes then NICE recommend the new treatment. In most cases though, new treatments are more expensive with potentially better outcomes. Here NICE assesses the extra increase in health divided by the extra increase in spending to give an incremental cost effectiveness ratio (ICER). NICE provides examples of NICE guidance that could generate cost savings. It also states that in some cases, implementing guidance will free up resources and capacity that can be used for other services. This results in improved productivity rather than delivering actual cash