AAO-HNS/F Position Statement Updates
Definition of a Position Statement: A Position Statement is used to designate a statement, policy, or declaration of the AmericanAcademy of Otolaryngology—Head and Neck Surgery, and Foundation (AAO-HNS/F) on a particular topic or topics. Statements are created to formalize the AAO-HNS/F position on a clinical procedure or medical service with third party payers, for use in state and federal regulatory or advocacy efforts, or to clarify the AAO-HNS/F approval or disapproval of certain practices in medicine. For information about the differences between Position Statements and other quality knowledge products, such as Clinical Practice Guidelines, view the AAO-HNS/F Guidance Documents fact sheet on the website (http://www.entnet.org/default/files/Guidance-Documents.pdf). How are AAO-HNS/F Position Statements Created and Approved? Have you ever wondered how a Position Statement is created and what is involved in the process of review and final approval by the Board of Directors? In response to questions like this one the Health Policy department and the Physician Payment Policy (3P) workgroup that oversees the review and maintenance of the Position Statements, published a guidance document for AAO-HNS/F committees with a step-by-step process on how to develop a Position Statement. Notably, this document defines a Position Statement, clarifies its process of development, and clarifies its purpose as an AAO-HNS/F resource. This guidance document can be found on the Academy’s website (http://www.entnet.org/sites/default/files/Position-Statement-Template.pdf). This article provides examples of how members use the resource as an advocacy tool or to clarify the AAO-HNS/F approval or disapproval of certain practices in medicine. How Are AAO-HNS/F Position Statements Used by Members as a Resource? Real Examples of how AAO-HNS/F Position Statements are used as a resource include: Position Statements can be used to advocate with payers regarding coverage policies and issues that members are experiencing with third party payers. Example: An otolaryngologist has difficulty getting approval for a surgery including uvulapalatopharyngoplasty (UPPP) and midline glossectomy as treatment of obstructive sleep apnea (OSA) in patients where continued positive airway pressure (CPAP) has failed as treatment. As rationale for the denial, the insurance reviewer states that there is a lack of literature supporting this approach. The physician appeals the denial using Academy position statements on UPPP, mid-line glossectomy, and surgical management of OSA. The insurer subsequently reviews the supporting documentation reinforced by peer-reviewed literature to determine whether or not to reverse the denial and approve payment of the claim. Position Statements are also used to promote the Academy’s position on specific medical procedures. Example: The Academy published a position statement noting that sinus ostial dilation is an appropriate therapeutic option for selected patients with sinusitis. The statement also includes a list of supporting literature to indicate why we support this procedure as an appropriate option for clinical management. The Academy has provided this Position Statement to dozens of private healthcare insurers and several have reversed their decision of experimental and investigational, and instead, allowed for coverage. What are the latest New or Revised Position Statements Approved by the AAO-HNS/F Board of Directors? After an extensive review by AAO-HNS/F committees, the Executive Committee, and Board of Directors, the AAO-HNS/F revised nine, and published three new, Position Statements. The AAO-HNS/F reviews all position statements on a rolling four-year basis. For a listing of the updated Position Statements [Communications insert standard language to drive members to Bulletin online.] The latest updates can be found on the AAO-HNS/F website at http://www.entnet.org/positionstatements. Any questions about position statements? Email the health policy team at healthpolicy@entnet.org.
Definition of a Position Statement:
A Position Statement is used to designate a statement, policy, or declaration of the AmericanAcademy of Otolaryngology—Head and Neck Surgery, and Foundation (AAO-HNS/F) on a particular topic or topics. Statements are created to formalize the AAO-HNS/F position on a clinical procedure or medical service with third party payers, for use in state and federal regulatory or advocacy efforts, or to clarify the AAO-HNS/F approval or disapproval of certain practices in medicine. For information about the differences between Position Statements and other quality knowledge products, such as Clinical Practice Guidelines, view the AAO-HNS/F Guidance Documents fact sheet on the website (http://www.entnet.org/default/files/Guidance-Documents.pdf).
How are AAO-HNS/F Position Statements Created and Approved?
How Are AAO-HNS/F Position Statements Used by Members as a Resource?
Real Examples of how AAO-HNS/F Position Statements are used as a resource include:
Position Statements can be used to advocate with payers regarding coverage policies and issues that members are experiencing with third party payers.
Example: An otolaryngologist has difficulty getting approval for a surgery including uvulapalatopharyngoplasty (UPPP) and midline glossectomy as treatment of obstructive sleep apnea (OSA) in patients where continued positive airway pressure (CPAP) has failed as treatment. As rationale for the denial, the insurance reviewer states that there is a lack of literature supporting this approach. The physician appeals the denial using Academy position statements on UPPP, mid-line glossectomy, and surgical management of OSA. The insurer subsequently reviews the supporting documentation reinforced by peer-reviewed literature to determine whether or not to reverse the denial and approve payment of the claim.
Position Statements are also used to promote the Academy’s position on specific medical procedures.
Example: The Academy published a position statement noting that sinus ostial dilation is an appropriate therapeutic option for selected patients with sinusitis. The statement also includes a list of supporting literature to indicate why we support this procedure as an appropriate option for clinical management. The Academy has provided this Position Statement to dozens of private healthcare insurers and several have reversed their decision of experimental and investigational, and instead, allowed for coverage.
What are the latest New or Revised Position Statements Approved by the AAO-HNS/F Board of Directors?
After an extensive review by AAO-HNS/F committees, the Executive Committee, and Board of Directors, the AAO-HNS/F revised nine, and published three new, Position Statements. The AAO-HNS/F reviews all position statements on a rolling four-year basis. For a listing of the updated Position Statements [Communications insert standard language to drive members to Bulletin online.] The latest updates can be found on the AAO-HNS/F website at http://www.entnet.org/positionstatements.
Any questions about position statements? Email the health policy team at healthpolicy@entnet.org.