THE POLICY FOLLOWS: A NEW THEORY FOR DEVELOPING A VALUE-BASED, POST- PANDEMIC HEALTH CARE SYSTEM IN THE UNITED STATES

Health care policy making, particularly as it relates to technology and innovation, is extraordinarily complex and often fraught with unforeseen consequences. This thesis explores the intricate political history and economic underpinnings of the American health care system, which have created the most expensive, and many would argue— most inefficient—system in the world. More specifically, it examines the impact of technology and innovation on the evolution of that system. The Policy Follows approach to health care policy making introduced in this thesis, provides a clear and forward- thinking approach to integrating research, evidence, and expertise into the creation of informed and impactful health policy. Recent, relevant case studies illustrate the pitfalls of aggressive or poorly-informed health care technology policies advanced by political or industry agendas without the guidance of adequate scientific support. I examine the impact of the COVID-19 pandemic on the health technology landscape, with particular attention to the precipitous expansion of telehealth and virtual care services as a means of addressing the associated challenges, and discuss the imminent policy and regulatory questions facing the health care system as it emerges from this unprecedented national state of emergency. Prior to the pandemic, the growth and adoption of telehealth across the country was greatly inhibited by a several key barriers, particularly state-by-state variation in policies, the conflicting incentives of a fee-for- service based system, and an overall lack of rigorous research to guide development. The Policy Follows approach elucidates the path forward, guided by research and expertise, to developing evidence-based health technology policies that will facilitate the post-pandemic transformation of health care in the U.S. into a more equitable, efficient, cost-effective, and integrated system