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Commentary by Dana Goldman
Outcomes Assessment and Health Care Reform - Jonathan Skinner, Amitabh Chandra, Eliott Fisher
Areas to address while attempting to reform the health care system in the United States include controlling excessive expenditures, restraining cost growth and enhancing quality of care. Technological assessment and cost effective principles have been posited as approaches to reform health care while improving quality of care.
In this paper, the authors assert that outcomes assessment, or the measurement of the efficiency of health care systems, can complement technology assessment in health care reform. They examined claims data on Medicare patients from 1992-2004 who had experienced an acute myocardial infarction (AMI), or heart attack in order to aggregate individual patient outcomes and costs and derive hospital-specific measures of efficiency.
Key Findings:
- Technology assessment did not fully explain actual mortality or expenditure growth in the hospitals studied.
- Changing incentive structures will be necessary to address the lack of efficiency in the health care system.
- As part of health care reform, the establishment of Accountable Care Organizations (ACOs) at hospitals or in physician groups would enhance efficiency and address increasing costs and gaps in quality.
As a complement to technology assessment, outcomes assessment is a promising approach to health care reform that addresses expenditures, cost growth, and quality care.
Keywords: Cost Effectiveness, Managing Inflation, Administrative Cost/Structure, Quality, Delivery Systems, Innovation