Evidence Mattersevidence matters

Harvey L. Neiman Health Policy Institute staff participated in AcademyHealth’s 2016 Annual Research Meeting (ARM), which took place in Boston, Mass., on June 26-28.

 ARM is a national forum showcasing cutting-edge health services research and encouraging its use in health policy and clinical practice. The focus of the three-day conference, Today’s Research Driving Tomorrow’s Outcomes, was reflected throughout the agenda and conveyed the vital role that evidence plays in the transformation of health care and delivery systems to improve health for the future. Throughout the course of the meeting, Neiman Institute staff attended sessions on relevant, high-quality health services research and analysis, including safety, quality and value measurement, public and population health, patient-centered outcomes research, and payment and delivery systems innovations.

During the conference, Darwyyn Deyo, MA, a research fellow at the Neiman Institute, presented research on Medicare imaging metrics and computed tomography (CT) scans. Deyo’s study, ‘The Effect of Utilization Regulation: The Case of CT Scans and the Affordable Care Act,’ found that the Outpatient Imaging Efficiency (OIE) measures can significantly reduce potentially unnecessary imaging, even when hospitals do not have direct control over physician ordering.

Deyo and her co-author Danny R. Hughes, PhD, the Neiman Institute’s senior director for health policy research, examined whether one of the OIE metrics (OP-14) changed same day imaging utilization for brain and sinus CTs. OP-14 tracks whether the same patient was given both a brain and a sinus CT on the same day in hospital outpatient facilities and emergency departments, with known exceptions excluded. Although there may be a rationale for doctors to order both these CTs for the same patient on the same day, these orders represent potentially unnecessary imaging.

evidence matters articleDeyo and Hughes developed a model of hospital and physician behavior in response to a regulatory change with anticipated future penalties. The model was tested using Medicare claims data from 2008-2013, three years before and two years after the introduction of OP-14. They found that the introduction of OP-14 significantly lowered the rate and likelihood of same day brain and sinus CTs occurring in outpatient hospitals. The likelihood of same day brain and sinus CT orders fell more in outpatient hospitals which had historically ordered more brain and sinus CTs before the introduction of OP-14. Notably, the passage of the Affordable Care Act (ACA) in 2010 did not affect the likelihood of same day imaging, possibly due to the increase in overall imaging utilization associated with the ACA.

Neiman Institute staff members, who returned reenergized after three days of educational sessions and panels, are already looking forward to next year’s ARM which will be held in New Orleans. Until then, they will follow AcademyHealth CEO Lisa Simpson’s charge to ARM attendees to continue producing research that will improve health and health care in the country.

“Your research, your methods, your data, matters. The evidence you produce matters. The data you analyze matters.”

Check out a Storify recap of the Neiman Institute staff’s experiences at ARM 2016.

By Nicole Racadag, communications manager for the Harvey L. Neiman Health Policy Institute

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