Treatment of Severe Chronic Illness: What Explains Cost and Quality Variations? Should We Be Concerned?

Some Medicare beneficiaries receive significantly more hospital-based services during the last two years of life than do other beneficiaries. The number of physician visits for Medicare beneficiaries can also vary greatly. What accounts for this variation? Do patients receiving more services tend to get better care, or not? Should policymakers take steps to more closely examine the relationship between spending and the volume of services provided at different facilities?

To help address these and related questions, the Alliance for Health Reform, the National Institute for Health Care Management (NIHCM) and the Robert Wood Johnson Foundation sponsored a September 8 luncheon briefing. Panelists were: Elliott Fisher, co-principal investigator of the Dartmouth Atlas Project, which has been analyzing and publishing Medicare data on spending and services since 1992; Sam Nussbaum, executive vice president and chief medical officer of Wellpoint, Inc., which provides health insurance, primarily through Blue Cross and Blue Shield companies, to 34 million members in 14 states; and Barry Straube, chief medical officer at the Centers for Medicare and Medicaid Services. Nancy Chockley of NIHCM and Ed Howard of the Alliance moderated the discussion.

Transcript

Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Barry Straube Presentation (Adobe Acrobat PDF)
Elliot Fisher’s Presentation (Adobe Acrobat PDF)
Sam Nussbuaum’s Presentation (Adobe Acrobat PDF)