Medicare

There are large hospital-to-hospital variations in the amount of resources used to care for critically ill patients who are covered by fee-for-service Medicare, as well as among patients covered by Medicare HMOs and nonelderly patients with private insurance, according to a study in Health Affairs.

The study, conducted in California hospitals, found the extent of variations in resource use among hospitals was as large for Medicare HMO and privately insured patients as it was for Medicare fee-for-service patients. Because the study examined similar cohorts of patients at each hospital and adjusted for potentially confounding factors, the variations most likely reflect differences in how hospitals use resources, rather than differences in patient characteristics, according to researchers.

The researchers write that if private or government payers only focus on the paid price or the length of an inpatient stay, policymakers will miss an opportunity to reduce overall resource use and improve the efficiency of care. The findings also suggest that both private and public payers could save money from efforts to align incentives for more efficient use of the hospital as a site of care, according to the researchers (Baker et al., Health Affairs, 2/12).