“While the reforms hit their mark, they did so in an unintended way,” said Professor Joel C. Cantor, director of
In diagnostic coronary angiography, a dye is injected into heart blood vessels so that X-rays can be used to accurately diagnose heart disease. Test utilization trends in the Northeast between 1995 and 2003 showed that African Americans were about 25 percent less likely to receive coronary angiography compared to whites. Angiography utilization among whites changed little following the
Prior to the reforms, 26
standards are achieved. The new regulations, which doubled the number of hospitals licensed for the testing, also required new angiography facilities to create outreach plans to improve access for traditionally underserved groups, including racial minorities.
However, none of the minority directed outreach efforts seems to have made any difference, but the overall increase in the number of sites did.
Previously, the 26 hospitals had no difficulty filling their beds with well-insured patients which left little capacity to serve the less-preferred, less well-insured patients. Once the new facilities came on line, the well-insured could go to other places, and many did. The hospitals licensed before reform – many located in urban areas – could no longer fill their angiography
“We believe that in light of these circumstances, the ‘incumbent’ (pre-reform) hospitals preferred to collect some revenue through Medicaid to collecting none, thus leading these hospitals to expand
The Center for State Health Policy (www.cshp.rutgers.edu) was established within Rutgers Institute for Health, Health Care Policy, and Aging Research in 1999 to inform, support and stimulate sound and creative state health policy in
The study was funded by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services under grant number R01-HS014191. It was co-authored by Cantor and Derek DeLia, faculty at Rutgers’ CSHP; Amy Tiedemann, Ph.D. and Ava Stanley, M.D., M.P.H., former members of the center research staff; and Karl Kronebusch, a faculty member at
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