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Related Experiment Videos

Using performance data to identify preferred hospitals.

Meredith B Rosenthal1, Mary Beth Landrum, Ellen Meara

  • 1Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Room 405, Boston, MA 02115, USA.

Health Services Research
|November 13, 2007
PubMed
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Different methods for ranking hospitals using cost and quality data yield varied results. Payers need clear prioritization and better methods to identify high-value hospitals for tiered networks.

Area of Science:

  • Health Services Research
  • Health Economics
  • Healthcare Management

Background:

  • Health plans and purchasers use cost and quality data to identify preferred hospitals for tiered networks.
  • Tiered networks aim to guide patients toward higher-value care options.

Purpose of the Study:

  • To explore the implications of current approaches used by health plans and purchasers to identify preferred hospitals for tiered networks using cost and quality information.
  • To compare the overlap in preferred hospital sets generated by different tiering strategies.

Main Methods:

  • Analysis of 2002 secondary data on hospital quality and costs in five US markets.
  • Comparison of four alternative tiering strategies combining quality and cost information.
  • Identification of hospitals ranking in the top quartile for each strategy and examination of set overlap.

Related Experiment Videos

Main Results:

  • Little overlap was found between hospitals preferred based on quality scores alone versus cost scores alone.
  • Commonly used strategies combining cost with minimal quality standards or equal weighting produced substantially different preferred hospital sets.
  • Significant variation exists in hospital rankings depending on the chosen tiering methodology.

Conclusions:

  • The lack of agreement among strategies highlights the need for clear prioritization by payers.
  • More rigorous methods are required to accurately identify high-value hospitals for tiered networks.
  • Current approaches may not consistently identify the same set of high-value providers.