"A policy is a temporary creed liable to be changed"

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Kaitlyn Dmyterko, senior writer

“A policy is a temporary creed liable to be changed, but while it holds good it has got to be pursued with apostolic zeal,” said political and ideological leader of India Mohandas Gandhi. Like Gandhi, news this week in the healthcare industry outlines several instances where improving policy could also improve care.

This week, a study published in the Journal of the American Medical Association found that African-American and elderly Medicare patients are more likely to be readmitted to the hospital compared to whites, particularly after cases of acute MI and congestive heart failure.

To improve these high readmission rates and better understand the disparities in the healthcare system, Drs. Karen E. Joynt and Andrian Hernandez told Cardiovascular Business News that 30-day readmission rates may not be the best measurement of hospital quality. Both alluded to the fact that policies within the healthcare system should be overhauled to have more of a focus on rewarding hospitals who improve their outcomes as an incentive to deliver better care.

Currently, the system segregates the inpatient and outpatient segments of care, and Hernandez says a better reward system could make these two silos come together.

Joynt offers that disease management systems and more social support systems must be integrated into practice and is particularly important after a patient leaves the hospital doors to help prevent readmission.

In other news, a Health Affairs study this week urged that policy makers must take into account how new technologies and devices are adopted and whether or not they are truly of benefit to patients. Dr. Laurence C. Baker told Cardiovascular Business News that policies must be put in place that outline the cost-effectiveness of new technologies and whether they will be a substitute or add-on to existing technologies.

For the study, the researchers evaluated the use of both CT angiography (CTA) and catheter angiography to image the carotid arteries. CTA tests were substituted for angiography in over 20 percent of the cases, however, they also noted that for each instance of substitution, there were almost three to four cases where CTA was performed on patients who previously would not have received any test.

The additional usage did not increase the number of patients treated for carotid artery disease. While CTA exams cost less than angiography, it (and other new technologies) will only be cost effective if they are aimed at patients who will benefit the most. It is this last aspect that often gets overlooked by policy makers when analyzing the costs of new technologies.

As the push for payment reform and and an overhaul of reimbursement models is on the horizon, particularly with accountable care organizations, a better reward system for hospitals would also help the fight and provide competition, incentives and hopefully close the gap within patient care. What do you think is the best strategy for closing these gaps of care? Write in and let us know.

On these topics, or others, please feel free to contact me.

Kaitlyn Dmyterko, senior writer