|Value Of Hospital Care Can Vary 40 Percent Across Regions Of The Country
The value of care offered to hospital patients can vary
by as much as 40 percent across the U.S., according to the latest
edition of the Hospital Value Index, a comprehensive study that
examined quality, affordability and efficiency, and patient
satisfaction at more than 3,000 hospitals.
"We found that the delivery of high value care is widely
divergent across the country, among regions, and even among markets,"
said Hal Andrews, CEO of Data Advantage, the company that developed the
Hospital Value Index.
"Measuring value in healthcare is more complex than
measuring solely quality or cost and represents a significant challenge
for every stakeholder who wants to improve healthcare."
The federal government is the nation’s largest
single purchaser of healthcare services through the Centers for
Medicare and Medicaid Services (CMS). Under its value-based purchasing
initiative, CMS proposes to reimburse hospitals based on performance
against established benchmarks. Since the initial release of the
Hospital Value Index in June 2008, policymakers, such as U.S. Senator
Max Baucus (D-Mont.), have increasingly endorsed value-based purchasing
as a key initiative in addressing the nation’s healthcare crisis.
A few examples:
Hospitals in the Northeast (also known as CMS Region I)
have hospital value scores some 40 percent better than those in the
Southwest (CMS Region IX). The sharp contrast between regions
highlights the complexity of measuring value. For example, some
hospitals provide similar quality at a lower cost, while others provide
higher quality at a similar cost.
Hospitals in New York and New Jersey (CMS Region II)
showed the highest Medicare costs per patient but also had the second
most favorable Hospital Value Index median score, indicating a possible
relationship between higher cost and better patient results.
Hospitals in the Mountain States, including Colorado and Montana (CMS Region VIII),
revealed the lowest Medicare costs per patient and scored third lowest
on the Hospital Value Index, questioning whether enough healthcare
dollars are being spent in the region to deliver the high value care
found in other regions.
Of the four best performing CMS regions, the hospitals
in Kansas, Nebraska, Iowa and Missouri (CMS Region VII) reported the
lowest average Medicare reimbursement per member per year for all
healthcare costs, indicating that these hospitals are able to offer
relatively high value at a relatively lowcost.
"These findings underscore that the variances in care
and performance are extreme and don’t correlate well to spending
or utilization. Our emphasis on CMS Regions demonstrates the challenges
ahead as value-based purchasing is implemented," said John Morrow, a
founder of 100 Top Hospitals: Benchmarks for Success, and a senior
advisor to Data Advantage.
As a living scorecard, the Hospital Value Index is
continually updated as new data and CMS methods are implemented. The
Hospital Value Index analyzed financial data on Medicare spending
submitted by more than 3,000 Medicare-certified general acute-care
hospitals to CMS. Each hospital is scored nationally on a 100-point
scale. The three elements of quality, affordability & efficiency,
and patient satisfaction are combined to create an aggregate National
Value Score for each hospital.
Additionally, the study found:
- The median Hospital Value Index score declined more than 8.5 percent since June 2008.
- Quality scores overall showed a significant decline,
partially due to the inclusion of CMS’ post-discharge mortality
data for heart attack, heart failure and pneumonia, which became
publicly available in December 2008.
- Patient safety, patient satisfaction, and
affordability and efficiency scores showed improvement across virtually
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