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Health Care Reform and the Trap of the "Iron Law"

By Val Weber | Friday, May 1, 2015

In the 1980s, American program evaluator Peter Rossi described an alarming phenomenon. He noted that as new social program models are implemented across a broad range of settings, their effect lessens and tends toward zero. What Rossi called his “Iron Law of Evaluation” is probably frustratingly familiar to those who work in health care improvement.

In a new post to the Health Affairs Blog by former IHI Fellow Rocco Perla, IHI researchers Amy Reid and Sandy Cohen, and IHI Senior Scientist Gareth Parry, the authors describe common, and interdependent, ways new models and interventions can fall afoul of Rossi’s Iron Law, and they recommend approaches to reduce the likelihood of this happening. They conclude that “…just because a pilot does not work everywhere does not mean it should be wholly abandoned… Evaluators and policymakers should understand where and why a model has worked and use that information to guide the adaptation and spread of a model.”

Read the full post on the Health Affairs Blog.


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