Why the Geographic Variation in Health Care Spending Can't Tell Us Much about the Efficiency Or Quality of Our Health Care System PDF Download
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Author: Louise Sheiner
Publisher:
ISBN:
Category : Medical care
Languages : en
Pages : 54
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Book Description
Author: Louise Sheiner
Publisher:
ISBN:
Category : Medical care
Languages : en
Pages : 54
Get Book Here
Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030928869X
Category : Medical
Languages : en
Pages : 207
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Book Description
Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain budgets at all levels of government and threaten the solvency of Medicare, the nation's largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger. Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less. Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients. Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.
Author: Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care
Publisher:
ISBN: 9780309387514
Category :
Languages : en
Pages : 206
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Book Description
Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain budgets at all levels of government and threaten the solvency of Medicare, the nation's largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger. Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less. Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients. Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309282829
Category : Medical
Languages : en
Pages : 54
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Book Description
Interim Report of the Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Health Care: Preliminary Committee Observations is designed to provide the committee's preliminary observations for the 113th Congress as it considers further Medicare reform. This report contains only key preliminary observations related primarily to the committee's commissioned analyses of Medicare Parts A (Hospital Insurance program), B (Supplementary Medical Insurance program) and D (outpatient prescription drug benefit), complemented by other empirical investigations. It does not contain any observations related to the committee's commissioned analyses of the commercial insurer population, Medicare Advantage, or Medicaid, which will be presented in the committee's final report after completion of quality-control activities. This interim report excludes conclusions or recommendations related to the committee's consideration of the geographic value index or other payment reforms designed to promote highvalue care. Additional analyses are forthcoming, which will influence the committee's deliberations. These analyses include an exploration of how Medicare Part C (Medicare Advantage) and commercial spending, utilization, and quality vary compared with, and possibly are influenced by, Medicare Parts A and B spending, utilization, and quality. The committee also is assessing potential biases that may be inherent to Medicare and commercial claims-based measures of health status. Based on this new evidence and continued review of the literature, the committee will confirm the accuracy of the observations presented in this interim report and develop final conclusions and recommendations, which will be published in the committee's final report.
Author: Jill Bernstein
Publisher:
ISBN:
Category :
Languages : en
Pages : 13
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Book Description
Dating back more than 40 years, a large body of research has identified wide geographic variation in fee-for-service Medicare spending and service utilization. A major early conclusion of geographic variation research was that care is provided much more efficiently in some areas of the United States than in others, with the implication that geography largely determines the care patients receive. As health care spending continues to outpace growth in the nation's economy, approaching one-fifth of gross domestic product, some policy makers have identified reducing unwarranted geographic variation in health care as a way to control spending without compromising access or quality. Analysis of Medicare fee-for-service claims data in particular has contributed to calls for public policies to induce health care providers and patients in high-cost areas to adopt what appear to be the markedly more-efficient practice patterns of low-cost areas.
Author: David S. Guzick
Publisher: JHU Press
ISBN: 1421438666
Category : Medical
Languages : en
Pages : 372
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Book Description
Why does US health care have such high costs and poor outcomes? Dr. David S. Guzick offers this critique of the American health care industry and argues that it could work more effectively by rebalancing care, cost, and access. For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal mortality, and the most inequitable access to physicians when adjusted for need. In An Introduction to the US Health Care Industry, Dr. David S. Guzick takes an in-depth look at this troubling issue. Bringing to bear his unique background as a physician, economist, former University of Rochester medical school dean, and former president of the University of Florida Health System, Dr. Guzick shows that what we commonly refer to as the US health care "system" is actually an industry forged by a unique collection of self-interested and disjointed stakeholders. He argues that the assumptions underlying well-functioning markets do not align with health care. The resulting market imperfections, combined with entrenched industry stakeholders, have led to a significant imbalance of care, cost, and access. Using a nontechnical framework, Dr. Guzick introduces readers to the economic principles behind the function—and dysfunction—of our health care industry. He shows how the market-based approach could be expected to remedy these problems while detailing the realities of imperfections, regulations, and wealth inequality on those functions. He also analyzes how this industry developed, presenting the conceptual underpinnings of the health care industry while detailing its history and tracing the creation and entrenchment of the current federation of key stakeholders—government, insurance companies, hospitals, doctors, employers, and drug and device manufacturers. In the final section of the book, Dr. Guzick looks to the future, describing the prevention, innovation, and alternative financing models that could help to rebalance the priorities of care, cost, and access that Americans need. An online supplement on COVID-19 is available, as is a discussion guide for instructors. To access this supplemental material, please visit www.jhupbooks.press.jhu.edu.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309113695
Category : Medical
Languages : en
Pages : 202
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Book Description
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309452961
Category : Medical
Languages : en
Pages : 583
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Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Author: Richard (Buz) Cooper
Publisher: Johns Hopkins University Press
ISBN: 1421429055
Category : Medical
Languages : en
Pages : 305
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Book Description
The first book to address the fundamental nexus that binds poverty and income inequality to soaring health care utilization and spending, Poverty and the Myths of Health Care Reform is a must-read for medical professionals, public health scholars, politicians, and anyone concerned with the heavy burden of inequality on the health of Americans.
Author: Derrick Watkins
Publisher:
ISBN: 9781634828765
Category : Medical care
Languages : en
Pages : 115
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Book Description
Research shows that spending on health care varies by geographic area and that higher spending in an area is not always associated with better quality of care. While a substantial body of research exists on geographic variation in spending in Medicare, less research has been done on variation in private sector health care spending, although this spending accounts for about a third of overall health care spending. As U.S. health expenditures continue to rise, policymakers and others have expressed interest in better understanding spending variation and how health care systems can operate efficiently--that is, providing equivalent or higher quality care while maintaining or lowering current spending levels. This book examines how spending per episode of care for certain high-cost procedures varies across geographic areas for private payers; and how the mix of service types, and the volume, intensity, and price of services contribute to variation in episode spending across geographic areas for private payers.
