Bardach’s Eightfold Path (policy analysis framework):
1. Define the problem
2. Assemble evidence
3. Construct alternatives
4. Select criteria
5. Project outcomes
6. Confront trade-offs
7. Decide
8. Tell your story
Addendum:
Giving credit: https://gspp.berkeley.edu/research-and-impact/faculty/eugene-bardach
Grok:
1. Define problem: Medicare denies coverage, classifying as non-medical; limits independence, worsens comorbidities (spasticity, bone loss, pressure injuries) in non-ambulatory users.
2. Assemble evidence: Peer-reviewed studies show benefits: ROM maintenance, spasticity reduction, bone density preservation, better bladder/bowel function, pressure relief, MRADLs independence (e.g., reaching, hygiene).
3. Construct alternatives: No change; legislative (separate CRT category); NCD reconsideration (reclassify as medical DME).
4. Select criteria: Beneficiary health/QoL/ethics (high weight); cost/admin feasibility.
5. Project outcomes: NCD change: medium-high benefit, potential cost-neutral via reduced hospitalizations; legislative: highest benefit but slow.
6. Confront trade-offs: NCD fastest/realistic; balances access vs. admin burden.
7. Decide: Pursue NCD reconsideration (2020 ITEM request pending/waitlisted as of 2026).
8. Tell story: Evidence supports primarily medical nature; coverage promotes independence, prevents complications.
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