| Does your agency include charge/cost data with quality reports? |
| Yes (0) |
 0% |
| No (0) |
| 0% |
| Plans to do this in the future (0) |
| 0% |
We at NAHDO are occasionally asked about the correlation between hospital quality and hospital spending. Many of our state members with public reporting initiatives do include resource use in terms of LOS and charges with quality reports, but efficiency scores/metrics are not uniform.
I would refer our members to the May 21, 2009 HEALTH AFFAIRS edition's article in the "Health Tracking" section, "Hospital Quality And Intensity of Spending: Is There An Association? Hospitals' performance on quality of care is not associated with the intensity of their spending". (Laura Yasaitis, Elliott S. Fisher, Jonathan S. Skinner, and Amitabh Chandra--Dartmouth).
Some take-aways from this "first nationwide analyses of quality and spending at the individual hospital level":
--spending intensity reveals the lack of positive association between quality and spending;
--prevalence of hospital with inefficient, fragmented care is not isolated to a few regions of the country;
--process measures (CMS and NQF-endorsed measures) do not require risk adjustment but they have a weak correlation to health outcomes, including mortality.
For NAHDO members, including additional reporting of spending should strengthen consumer reporting efforts and improve public reporting on quality AND spending will help advance understanding about how some providers can deliver high quality care without high expense. Medicare Part A and B data were used for this study, underscoring the continued importance that administrative/claims data will play in analyzing efficiency and provide more evidence that states must pursue All Payer Claims data reporting to augment their facility data systems.
Denise Love
Executive Director
NAHDO
dlove@nahdo.org