The medical device industry is growing rapidly, with an estimated market over $300 billion globally. At the same time, cost containment pressures have translated into hospitals creating new decision-making processes and structures to control costs.  In many hospitals, technology assessment committees (TACs), or value analysis committees (VACs), are a central feature of these cost containment strategies for medical devices.  The question of what constitutes current decision-making processes and evidence needs of TACs/VACs, and more importantly, how evidence can best be communicated and leveraged, is central to the successful adoption of medical devices within hospitals. Our aim was to provide insight into evolving global hospital TAC/VAC requirements and to recommend a framework to deliver these requirements.  A literature review was undertaken, in conjunction with case studies, to identify current TAC/VAC processes, member perspectives, decision-making factors (including evidence needs), and key challenges.  Based on this evidence, a conceptual framework was developed which is composed of a systematic set of activities pertaining to “identifying”, “demonstrating” and “communicating” medical device value for enhanced product adoption.  Central components of this framework, which have been tested in the field, include development of concise evidence-based payer dossiers and value messages, as well as sales force models that encompass both clinical and economic endpoints.  Case studies of such tools, developed across diverse therapeutic areas (e.g., cardiovascular disease stenting, laparoscopic surgery), illustrate common and essential components.  These include the need for indirect comparison methods when head-to-head comparative effectiveness data are lacking for appropriate medical device alternatives.  In addition, data on outcomes relevant to the hospital from a cost-efficiency and quality improvement standpoint must be integrated. Testing of these tools has underscored the importance of customization of model parameters to hospital settings.