AV: I totally agree. When I think of health policy research, I think of it as the engine of what we call the evidence-based policy movement. I think a lot of emergency physicians and clinicians are very comfortable with the term “evidence-based medicine.” Why don’t we use the same scientific rigor to analyze data and inform the policies we make? CMS [the Centers for Medicare & Medicaid Services] is going to rethink how they pay for hip and knee replacements, and they’re actually doing a randomized study where certain counties in America are going to be paid differently than other counties. Rather than just set payment policy based on a couple of anecdotes or stories, they’re developing a plan and will implement, study, and evaluate it to decide how future payment policy is set across the U.S.
Explore This IssueACEP Now: Vol 35 – No 06 – June 2016
ML: I think of health policy research as investigating the policies that improve the actual delivery of care because if we have the greatest scientific advances but we’re not able to implement policies that get those advances to patients in an efficient and equitable way, patients can’t be benefited.
SA: Why is it important to do health policy research?
SS: It’s vital that we understand the forces that drive health care and their effect on patients and the general population. While an individual experience is important, viewing their effect on health care through too small of a lens gives you too distorted a view of the effect. The effect of the ACA [Patient Protection and Affordable Care Act] on any given individual may be positive or negative. One person may have coverage for the first time, while another may be struggling with a high deductible. The effect of the ACA in terms of its cost will not be understood for years. Understanding the effects and improvements of the provision of care is really the goal of health policy research.
VF: Another reason we need to do health policy research is that policy is created on the basis of anecdotal evidence. One of the great urban myths that we fight in emergency medicine is that family practice and the medical home will cure all of the ills of society. What they do is different fundamentally than what we do in terms of the kind of health care they provide. In emergency medicine, there were very few people studying this, yet we’re the target of many, many health policies, most of which are negative for our specialty.