**4. Implementation process**

Before releasing the model to provincial insurers, further pilot testing would be recommended. Ideally, a selected group of insurance experts would be asked to use the model in the assessment of their own insurance options and, in parallel, the two "standard" options as described above.

After the evaluation, the pilot users should be interviewed for their experience in the process and suggestions for improvement. This feedback could be used for building a next version tool, which could then be presented to the State Medical Insurance Bureau and released to a broader user group. In addition, guidance and training material should be developed to support interrater consistency in the application of the model. Dissemination could happen via various channels such as the State Medical Insurance Bureau or presentations and workshops at provincial or national conferences where insurance policy experts come together.

As mentioned above, the use of the model should be accompanied by an ongoing collection for user feedback (e.g., in an online survey format) and regular revision of the tool for further adaptation to new application requirements.
