The pillars of an essential health benefits package are medical effectiveness, safety, and their relative value compared with alternatives, the Institute of Medicine suggested last week. Working out the details, however, is up to the Department of Health and Human Services, which has announced that it will seek public opinion on what health insurance exchanges must offer.
The Institute of Medicine unveiled last week the processes and procedures it recommends that HHS follow in the development of the health benefits package that will be offered by health insurance exchanges (HIX). That effort involved an 18-member committee comprised primarily of representatives from organized stakeholder groups.
Keith Maley, an HHS spokesperson, said in an interview that the agency will focus for the time being on getting public input on the development of essential health benefits. The IOM has recommended a public process for both defining and updating the EHB package.
In its report, Essential Health Benefits: Balancing Coverage and Cost, the IOMsaid the public deliberation process "would enable individuals? working in small group meetings around the country?to participate in a prioritization process, where different elements of coverage?specific services, types of cost-sharing, degree of provider choice, approval requirements, etc.?are discussed and debated."
In a press statement Secretary Kathleen Sebelius stressed the importance of the "listening sessions where Americans from across the country will have the chance to share their thoughts on these issues but offered no commitment to the structure of the sessions themselves or their locations.