Geographic value index may not produce efficient care

April 4, 2013
Geographic value index may not produce efficient care
A geographically based value index to set Medicare reimbursements may not take into account differences in health care decision-making by individual practitioners or organizations, according to an interim report released March 22 by the Institute of Medicine (IOM).

(HealthDay)—A geographically based value index to set Medicare reimbursements may not take into account differences in health care decision-making by individual practitioners or organizations, according to an interim report released March 22 by the Institute of Medicine (IOM).

The IOM committee is conducting an ongoing, congressionally mandated study of regional variations in , use, and quality, as well as the merits of adopting a geographic value index. The group reviewed published research, testimony at two public workshops, new statistical analyses conducted by six subcontractors, and four papers commissioned from experts on Medicare spending.

The committee found that there is great national variation in the amount that Medicare spends per person. Between regions, the variation is as large as 44 percent. Increased spending does not consistently translate into better health outcomes or greater patient satisfaction. Differences in use of services and spending also occur between providers within a single region and between providers within a single hospital or group practice. A significant amount of in Medicare payments remains unexplained, even after adjusting for (wages and rents) and patient attributes. Variation in post-acute care (home health services, skilled nursing facilities, rehabilitation facilities, long-term care hospitals, and hospices) account for a substantial amount of the variation in for health care services, followed by differences in in-patient care. Very little spending difference stems from prescription drugs, diagnostics, procedures, and emergency department visits.

"To be effective, payment reforms need to encourage behavioral changes at the point of health care decision making, which occurs at the level of individual providers and ," the committee said in a statement.

Explore further: Medicare spending for advanced cancer not linked to survival differences

More information: More Information

Related Stories

Medicare spending for advanced cancer not linked to survival differences

March 12, 2013
Substantial regional variation in Medicare spending for patients with advanced cancer is not linked to differences in survival, according to a study published March 12 in the Journal of the National Cancer Institute.

Revised geographic adjustments could improve accuracy of Medicare payments

July 17, 2012
Changing the way that Medicare payments are adjusted to account for regional variations in the cost of providing care as recommended by a previous report from the Institute of Medicine would result in payment increases for ...

Healing cuts for Medicare

September 4, 2012
Medicare payment reforms mandated in the Affordable Care Act (ACA) for postacute care have great potential to lower costs without harming patients, a new study reports.

Regional analysis masks substantial local variation in health care spending

October 31, 2012
Reforming Medicare payments based on large geographic regions may be too bluntly targeted to promote the best use of health care resources, a new analysis from the University of Pittsburgh Graduate School of Public Health ...

Recommended for you

Study finds walnuts may promote health by changing gut bacteria

July 28, 2017
Research led by Lauri Byerley, PhD, RD, Research Associate Professor of Physiology at LSU Health New Orleans School of Medicine, has found that walnuts in the diet change the makeup of bacteria in the gut, which suggests ...

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.