variation in health care spending

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Geographic Variation In Health Care Spending

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ISBN : OCLC:212202900
Genre : Medical care
File Size : 27. 14 MB
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Variation In Health Care Spending

Author : Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care
ISBN : 0309387515
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File Size : 44. 35 MB
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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.

Geographic Variation Of Health Care Spending On Heart Failure In Metropolitan Areas

Author : Kevin McMillan
ISBN : OCLC:961909002
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File Size : 58. 3 MB
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The costs of healthcare have long been a concern in the United States. It is well known that these costs vary geographically, but attempts to explain this variation have been met with limited and varied success. This is partly attributable to the fact that data available have restricted analyses to assessing the issue to using Medicare cost per beneficiary. In June, 2013, the Center for Medicare and Medicaid Services (CMS) released new Medicare data that detailed the charges and payments made to hospitals throughout the United States in 2011. In this thesis, this new dataset was used to examine costs of treatment for heart failure, a widespread and serious health concern in the U.S.. Costs were examined from two perspectives: the average Medicare payments and the average amount hospitals charged within metropolitan areas. Ordinary Least Squares (OLS) regression analysis was used in an attempt to explain geographic variation in the Medicare payments for the treatment of heart failure in Metropolitan Statistical Areas (MSAs) based on six key demographic variables identified from previous research on spending per Medicare beneficiary. Additionally, these demographic variables were applied to the average amount hospitals charged for the treatment of heart failure. These six variables include the percent African American, the percent with a Bachelor’s degree or higher, the average number of hospital discharges for heart failure, the percent female, the percent in poverty, and the percent aged sixty-five and older. Results suggest that variables with a key relationship to Medicare payments for the treatment for heart failure include the percent with a Bachelor’s degree or higher and the percent aged sixty-five or older within a MSA. Key variables correlated with the average amount hospitals charged for the treatment of heart failure in a MSA include the average number of hospital discharges for heart failure, the percent female, and the percent aged sixty-five and older within a MSA.

Interim Report Of The Committee On Geographic Variation In Health Care Spending And Promotion Of High Value Health Care

Author : Institute of Medicine
ISBN : 9780309282826
Genre : Medical
File Size : 75. 66 MB
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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.

Milwaukee Health Care Spending Compared To Other Metropolitan Areas Geographic Variation In Spending For Enrollees In The Federal Employees Health Benefits Program

Author :
ISBN : 9781428937482
Genre :
File Size : 73. 39 MB
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Geographic Variation In Health Care Spending And The Politics Of State Medicaid Policy

Author : Gideon Lukens
ISBN : OCLC:774073053
Genre : Medicaid
File Size : 26. 90 MB
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Quality Care Affordable Care

Author : LAWRENCE SHAPIRO, MD.
ISBN : 0991013514
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File Size : 88. 25 MB
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