PRIORITIZATION OF HEALTH SERVICES A Report to the Governor and the 77 th Oregon Legislative Assembly Health Evidence Review Commission Office for Oregon Health Policy and Research Oregon Health Authority 2013 TABLE OF CONTENTS List of Figures . iv Health Evidence Review Commission and Staff . .v Acknowledgments . .vi Executive Summary . vii CHAPTER ONE: PRIORITIZATION OF HEALTH SERVICES FOR 2014-15 Charge to the Health Evidence Review Commission . 2 Prioritization Methodology . 3 Biennial Review of the Prioritized List . 6 Interim Modifications to the Prioritized List . 19 Technical Changes . 20 Advancements in Medical Technology . 26 Prioritization of Medications and Other Ancillary Services . .. 28 Therapies With Marginal Benefit Or High Cost . 29 CHAPTER TWO: CLARIFICATIONS TO THE PRIORITIZED LIST OF HEALTH SERVICES Practice Guidelines . 32 Guidelines on Ancillary and Diagnostic Services Not Appearing on the Prioritized List . .32 Advanced Imaging For Low Back Pain . .. 33 Breast Cancer Screening . 35 Neuroimaging For Headache . 36 Neuroimaging in Dementia . .. 36 Non-Prenatal Genetic Testing . .. 37 Guideline Notes For Health Services That Appear On The Prioritized List . .42 Acne Conglobata. 42 Acromioclavicular Joint Sprain, Management of . 42 Acupuncture. 42 Acute Viral Infections, Hospitalization for . 43 Artificial Disk Replacement . 45 Bariatric Surgery. 46 Benign Neoplasm Of Urinary Organs, Treatment Of. .47 Blepharoplasty. .48 Bone Tumors, Benign . .48 Breast Reconstruction. .48 Cataract. 48 Cesarean Delivery, Planned. .49 Chemodenervation of the Bladder. .49 Cognitive Rehabilitation. .49 Collapsed Vertebra. .50 Dental Services Basic Peridontics. .. 51 Frenulectomy/Frenulotomy. 51 Oral Surgery. .52 Posterior Composite Restorations, One Surface (Deleted). 52 Preventive Dental Care. 52 Removeable Prosthodontics. 52 Silver Compounds For Dental Caries. 53 Dysmenorrhea. 53 Endometriosis and Adenomyosis. .54 Enzyme Replacement Therapy. 55 i TABLE OF CONTENTS (CONT’D) CHAPTER TWO: CLARIFICATIONS TO THE PRIORITIZED LIST OF HEALTH SERVICES (CONT’D) Practice Guidelines (Cont’d) Erythropoiesis-Stimulating Agent (ESA). 55 Foreign Bodies in the GI Tract. .. 56 Gender Dysphoria . 56 Heart-Kidney Transplants. .56 Hemangiomas, Complicated. .56 Hidden Penis Repair. .57 Hip Resurfacing. 57 Hyperbaric Oxygen. 58 Hypotony. 58 Implantable GNRH Analog Therapy. 58 Induction of Labor, Elective. 59 Influenza. 59 Injuries To Ligaments And Tendons, Significant. .59 Injury, Nerve, Acute Peripheral Motor and Digital. .59 Laryngeal Stenosis or Paralysis with Airway Complications. .60 Low Back Pain, Epidural Steroid Injections and Other Percutaneous Interventions For. 60 Low Back Pain, Evaluation and Management. 61 Medical Nutrition Therapy For Epilepsy . .61 Menstrual Bleeding Disorders. .61 Minimally Invasive Coronary Artery Bypass Surgery (deleted) . .62 Multiple Sclerosis, Immune Modifying Therapies for. 62 Nasolacrimal Duct Obstruction, Neonatal. 62 Non-Pharmacologic Interventions for Treatment-Resistant Depression. 63 Organic Mental Disorders. 63 Otitis Media With Effusion, Chronic . 63 Pelvic Pain Syndrome. 64 PET Scan . 65 Prenatal Ultrasound, Routine. .66 Preventive Services. .67 Progesterone Containing IUDs for Non-Contraceptive Indications . .67 Rehabilitative Therapies. .68 Skin Disease, Severe Inflammatory. .69 Smoking and Spinal Fusion. .69 Spinal Deformity, Clinically Significant. .70 Spine Disorders With Neurologic Impairment. 70 Urinary Incontinence. 70 Uropathy, Obstructive and Reflux. ..