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Explore the findings on geographic variation in health care spending and promotion of high-value care. Learn about the complexities and factors influencing spending differences at all levels of the system. This report emphasizes the need for fair performance metrics, accountability, and evidence-based practices.
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AHA Task Force on Variation in Health Care Spending Report to the Institute of Medicine Committee on Geographic Variation In Health Care Spending and Promotion of High-Value Care January 17, 2011
Findings • Variation exists at all levels of the system and within the hospital itself • Regions with high levels of spending don’t necessarily have high spending growth • Variation in performance goes beyond spending • Regional variation in service use is not the same as variation in spending • Some spending differences are due to forces beyond a provider’s control • While financial incentives matter, providers respond to data
Findings Many Factors Influence Variation
Findings . Percent of Variation in Spending per Medicare Beneficiary Explained by Various Factors Source: Deb, Partha. Explaining Geographic Variation in Spending per Medicare Beneficiary. March 2010. Includes spending for Parts A&B.
Conclusions • The hospital field is committed to action but cannot tackle it alone • Fair performance metrics needed to hold providers accountable • Assign accountability to providers not geographic areas • Distinguish appropriate from inappropriate variation • Adjust for factors beyond the control of providers • Need for better evidence base, timely data across the continuum and tools
