Health policies are often implemented without evidence, according to Austin Frakt, PhD, a health economist, professor of public health and director of Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System.
"Rigorous evaluations of health policy are exceedingly rare," Dr. Frakt writes in The New York Times.
The U.S. spends less than 0.1 percent of healthcare dollars on evaluating policy, he notes. Even the Center for Medicare and Medicaid Innovation, which was created under the ACA to test and evaluate new models of care, often does not use randomized program design and allows for voluntary participation due to the complexities of doing so. Dr. Frakt notes just one of six bundles created by CMMI was randomized, and it was rendered optional after one year.
He notes that many common ideas in healthcare policy are not based in evidence. For example, the theory that hospitals lean more heavily on private payers to make up for reduced Medicare and Medicaid rates "is almost never observed," according to Dr. Frakt.
More research and evaluation is needed, he writes.
Read the full column here.
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