Table I Organizational structure What... | Emerald Publishing

Table I

Organizational structure

What works (or what is needed)	What does not work
Leadership that strongly supports priority setting and a culture conducive to making trade-off decisions, with support from clinical champions (Peacock et al., 2006; Ruta et al., 2005)	Preset budgets with no flexibility and no support. In other words, hard caps alone and strict adherence to a cost-effectiveness threshold are not the solution (Donaldson et al., 2002)
Strong, credible health technology assessment (HTA) to provide key information to the organizations that manage care and further, to facilitate consistency in the measurement of the clinical impact across organizations	Overreach of central HTA agencies as they move from evidence assessment to wanting a greater role in choice making (Sawyer and McDermott, 2019). HTA is best seen as an input into a broader priority setting framework
Project management to support priority-setting activity coupled with regular communication with internal and external stakeholders (Smith et al., 2016) to gain credible commitment, i.e., organizational trust (Jan, 2003)	Copayments as a form of incentive to ensure proper use of covered services and legislating cost control measures such as ways to increase efficiencies by specifying certain practices or incentives to compensate for market shortcomings

What works (or what is needed)	What does not work
Leadership that strongly supports priority setting and a culture conducive to making trade-off decisions, with support from clinical champions (Peacock et al., 2006; Ruta et al., 2005)	Preset budgets with no flexibility and no support. In other words, hard caps alone and strict adherence to a cost-effectiveness threshold are not the solution (Donaldson et al., 2002)
Strong, credible health technology assessment (HTA) to provide key information to the organizations that manage care and further, to facilitate consistency in the measurement of the clinical impact across organizations	Overreach of central HTA agencies as they move from evidence assessment to wanting a greater role in choice making (Sawyer and McDermott, 2019). HTA is best seen as an input into a broader priority setting framework
Project management to support priority-setting activity coupled with regular communication with internal and external stakeholders (Smith et al., 2016) to gain credible commitment, i.e., organizational trust (Jan, 2003)	Copayments as a form of incentive to ensure proper use of covered services and legislating cost control measures such as ways to increase efficiencies by specifying certain practices or incentives to compensate for market shortcomings