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Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      524128 Other Direct Insurance (except Life, Health, and Medical) Carriers
      524114 Direct Health and Medical Insurance Carriers
      524112 Direct group life, health and medical insurance carriers
      524210 Insurance Agencies and Brokerages
      524111 Direct individual life, health and medical insurance carriers
    • Abstract:
      Reforming payment methods to move away from fee-for-service reimbursement is widely seen as a crucial step toward controlling health care costs. Although there is a good deal of evidence about variability in costs under Medicare, little has been published about the variability of costs for care that is financed by private insurance. We examined both quality and actual medical costs for episodes of care provided by nearly 250,000 US physicians serving commercially insured patients nationwide. Overall, episode costs for a set of major medical procedures varied about 2.5-fold, and for a selected set of common chronic conditions, episode costs varied about 15-fold. Among doctors meeting quality and efficiency benchmarks, however, costs for episodes of care were on average 14 percent lower than among other doctors. Some markets exhibited much higher variation in episode costs, but there was essentially no correlation between average episode costs and measured quality across markets. The overall analysis suggests that changing incentives through payment reforms could help to improve performance, but providers are at different stages of readiness for such reforms and thus will often need support in order to succeed. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Senior V.P., UnitedHealth Center for Health Reform and Modernization, Washington, D.C.
      2Senior V.P. for Clinical Advancement, UnitedHealth Group, Minnetonka, MN
      3Senior Analyst, Medicare Division of UnitedHealthcare, Minnetonka, MN
      4Chair of the UnitedHealth Center for Health Reform and Modernization, Minnetonka, MN
      5Executive Vice President of UnitedHealth Group, Minnetonka, MN
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2012.0361
    • Accession Number:
      79834618
  • Citations
    • ABNT:
      ELLIS, P. et al. Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care. Health Affairs, [s. l.], v. 31, n. 9, p. 2084–2093, 2012. DOI 10.1377/hlthaff.2012.0361. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=79834618&custid=s8280428. Acesso em: 3 jul. 2020.
    • AMA:
      Ellis P, Sandy LG, Larson AJ, Stevens SL. Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care. Health Affairs. 2012;31(9):2084-2093. doi:10.1377/hlthaff.2012.0361.
    • AMA11:
      Ellis P, Sandy LG, Larson AJ, Stevens SL. Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care. Health Affairs. 2012;31(9):2084-2093. doi:10.1377/hlthaff.2012.0361
    • APA:
      Ellis, P., Sandy, L. G., Larson, A. J., & Stevens, S. L. (2012). Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care. Health Affairs, 31(9), 2084–2093. https://doi.org/10.1377/hlthaff.2012.0361
    • Chicago/Turabian: Author-Date:
      Ellis, Philip, Lewis G. Sandy, Aaron J. Larson, and Simon L. Stevens. 2012. “Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care.” Health Affairs 31 (9): 2084–93. doi:10.1377/hlthaff.2012.0361.
    • Harvard:
      Ellis, P. et al. (2012) ‘Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care’, Health Affairs, 31(9), pp. 2084–2093. doi: 10.1377/hlthaff.2012.0361.
    • Harvard: Australian:
      Ellis, P, Sandy, LG, Larson, AJ & Stevens, SL 2012, ‘Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care’, Health Affairs, vol. 31, no. 9, pp. 2084–2093, viewed 3 July 2020, .
    • MLA:
      Ellis, Philip, et al. “Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care.” Health Affairs, vol. 31, no. 9, Sept. 2012, pp. 2084–2093. EBSCOhost, doi:10.1377/hlthaff.2012.0361.
    • Chicago/Turabian: Humanities:
      Ellis, Philip, Lewis G. Sandy, Aaron J. Larson, and Simon L. Stevens. “Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care.” Health Affairs 31, no. 9 (September 2012): 2084–93. doi:10.1377/hlthaff.2012.0361.
    • Vancouver/ICMJE:
      Ellis P, Sandy LG, Larson AJ, Stevens SL. Wide Variation In Episode Costs Within A Commercially Insured Population Highlights Potential To Improve The Efficiency Of Care. Health Affairs [Internet]. 2012 Sep [cited 2020 Jul 3];31(9):2084–93. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=79834618&custid=s8280428