Implementing evidence-based medicine through medicare coverage decisions.

Management of technology diffusion to improve quality and constrain spending in health care remains an elusive goal. Along with efforts to improve the quality of evidence, providers and payers must ensure that evidence actually effects changes in practice. Medicare coverage policies grant, limit, and condition payment based on evidentiary standards. This paper identifies the sizable barriers to implementation of evidence-based medicine in Medicare and proposes policy solutions to address them.