Unbiased Analysis of Today's Healthcare Issues
Typically, Nursing Home quality is measured using metrics from Nursing Home Compare. These metrics are calculated based on survey and certification processes and resident assessments from from the Minimum Data Set (MDS). These, however, are not the only quality metrics one can use. For instance, one can use consumer complaints as a measure of quality…
How does one measure hospital quality? Quality occurs along multiple dimensions. Thus, to summarize overall quality, one must create a weighting scheme to compete the distinct quality measures in a single measure. In most cases, quality measures should also account for differences in patient case mix. Hospitals should not be punished with lower quality scores…
Often, this is done with claims-based measures and beneficiary surveys. Today, I take a more detailed look at the UnitedHealth Premium physician designation program. The program evalutates physicians based on established quality measures and–for those who meet the minimum quality requirement–a measure of efficiency (i.e., low cost). A more detailed description is available here. Without…
Some background: Created in March 2007, the PQRI established a financial incentive for eligible healthcare professionals to participate in a voluntary quality reporting program. By reporting on a minimum of 3 measures on a specified group of patients, a physician can earn a bonus payment of 0.5% on all of their Medicare billing for 2012.…
The UnitedHealth Premium Physician Designation Program assesses the quality and efficiency of physicians’ practice patterns. UnitedHealth uses Quality of care is measured using measures from the NQF and NCQA. Cost efficiency (i.e., being low cost) is measured using the Symmetry ETG and PEG episodes. The information generated by this program is used to i) give…
In the U.S. patients can use Hospital Compare to evaluate the quality of care individuals receive at each hospital in the U.S. In Italy, there is P.Re.Val.E. A paper by Renzi et al. explains: A Regional Outcome Evaluation Program (P.Re.Val.E.) was launched in the Lazio region of central Italy starting in 2005 (Fusco et al.…
Shrinkage estimators (such as the James-Stein estimator) are well-known in the economics literature and have a number of applications. A recent paper by Shwartz et al. 2012 demonstrates how one could apply shrinkage estimators to measure nursing home quality. “A challenge when examining individual QIs across a range of facilities is that sample sizes are…
A number of studies have already examined this question. Baker et al. (2003) examined the effectiveness of a public reporting effort in hospitals in Ohio, finding little relationship between a hospital’s report card ranking and changes in its market share. Cutler et al. (2004) examined the effects of reporting quality information about cardiac surgery on…
Medicare’s Hospital Compare website evaluates hospital quality. One of the most recent measures to be added to Hospital Compare is a measure of efficiency. The measure calculates a price-standardized, case-mix adjusted measure of spending during period before, during and after a hospital admission. The Healthcare Economist (Jason Shafrin) and a team at Acumen (including Tom…
The N.Y. Times has an interesting article citing a number of reasons why there are no good websites with doctors reviews on the web. There are some ratings websites (HealthGrades, RateMDs, Angie’s List, Yelp), but the listings are often sparse, with few contributors and little of substance.) For one, physicians don’t like them. “Several years ago,…