Case Studies

Care Variation Analysis expanded to include Appropriateness and Intensity

Client: Regional Data-Pooling Collaborative, 2008-2011

Patient Residence may Influence Choice of Treatment; Care Content for Similar Treatments Can Vary Significantly

This project represents an important step in broadening community performance measurement to address additional domains that impact health care value.

The client writes: "With its work on resource use, the Alliance is introducing two components of value in health care: appropriateness and intensity. The focus is on services which are preference-sensitive (i.e., surgery is not the only treatment option) and/or supply-sensitive (i.e., the availability of services drives their use) and where variation may represent overuse.

Download the report (2.3 MB .pdf)

"The Alliance is looking at both the frequency with which a treatment occurs, as well as the service intensity of the treatment itself. Since frequency and intensity can each vary significantly, understanding, measuring, and revealing this variation is an important step in assessing the value of our health care system.

"The data the Alliance analyzed will have practical implications for the region. All else equal, delivery systems with more consistent, low-intensity service patterns will appeal both to employers and to hospitals and medical groups. Employers could use the data to identify treatments and delivery systems where discretionary services are less likely to occur. Providers could use the data to identify sources of variation that could threaten their ability to succeed with payment reforms, such as bundled payment."

Download the report (2.3 MB .pdf)