Interim Report of the Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care. Preliminary Committee Observations.

摘要

In 2009, following negotiations related to passage of the Patient Protection and Affordable Care Act (ACA), a group of U.S. House of Representatives members, known as the Quality Care Coalition, asked the Secretary of the U.S. Department of Health and Human Services (HHS), Kathleen Sebelius, to sponsor two Institute of Medicine (IOM) studies focused on geographic payments under Medicare, independent of final health reform legislation (Sebelius, 2010). The first study evaluated the accuracy of Medicare's geographic adjustment factors, which alter physician and hospital payment rates based on specific, geographically based input prices (IOM, 2011, 2012). For the second study, the subject of this interim report, the IOM Committee on Geographic Variation in Health Care Spending and Promotion of High-Value Care (the committee) was asked to investigate geographic variation in health care spending and quality and to analyze Medicare payment polices that could encourage high-value care, including adoption of a geographically based value index. This index would account for both the health benefit obtained from health care services delivered and the cost of those services, as discussed later in this report.