Associations between hospital quality outcomes and Medicare spending per beneficiary in the USA

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Gunn, L., Cook, K., Perry, I. ’sis, Hoke, C., Smith, D., Peterson, L., … Foster, B. (2021). Associations between hospital quality outcomes and Medicare spending per beneficiary in the USA. Healthcare. https://doi.org/doi:10.3390/healthcare9070831
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Description

The cost of healthcare in the United States has increased over time. However, patient health outcomes have not trended with spending. There is a need to better comprehend the association between healthcare costs in the United States and hospital quality outcomes. Medicare spending per beneficiary (MSPB), a homogeneous metric across providers, can be used to evaluate the association between episodic Medicare spending and quality of care. Fifteen inpatient outcome measures were selected from Hospital Compare data among all (n = 4758) facilities and transformed to quintiles to ensure comparability across measures and to reduce the influence of outliers on the analysis. Both univariate and multiresponse multinomial ordered probit regression models were utilized across outcome domains to quantify associations between outcomes and spending. We found that MSPB was not associated with quality of care in most cases, adding evidence of a lack of outcome accountability among Medicare-funded facilities. Furthermore, worse outcomes were found to be associated with increased spending for some metrics. Policies are needed to align quality of care outcomes with the increasing costs of U.S. healthcare.

Details
Title

Associations between hospital quality outcomes and Medicare spending per beneficiary in the USA

Author(s)

Gunn, Laura
Cook, Karyn
Perry, I’sis
Hoke, Christy
Smith, Dana
Peterson, Leanne
Martin, John
Korvink, Michael
Foster, Brent

UNC Charlotte Affiliate Type

Faculty

Publisher

MDPI

Extent

1 online resource

Date Published

2021

Material Type

Journal article

Genre

articles

Resource Type

text

Abstract

The cost of healthcare in the United States has increased over time. However, patient health outcomes have not trended with spending. There is a need to better comprehend the association between healthcare costs in the United States and hospital quality outcomes. Medicare spending per beneficiary (MSPB), a homogeneous metric across providers, can be used to evaluate the association between episodic Medicare spending and quality of care. Fifteen inpatient outcome measures were selected from Hospital Compare data among all (n = 4758) facilities and transformed to quintiles to ensure comparability across measures and to reduce the influence of outliers on the analysis. Both univariate and multiresponse multinomial ordered probit regression models were utilized across outcome domains to quantify associations between outcomes and spending. We found that MSPB was not associated with quality of care in most cases, adding evidence of a lack of outcome accountability among Medicare-funded facilities. Furthermore, worse outcomes were found to be associated with increased spending for some metrics. Policies are needed to align quality of care outcomes with the increasing costs of U.S. healthcare.

Subjects--Topics

Medicare
Hospital care

Is Part Of

Healthcare

Language

English

Published Version (Please cite this version)

doi:10.3390/healthcare9070831

Publisher's Version

https://www.mdpi.com/2227-9032/9/7/831

Permalink

http://hdl.handle.net/20.500.13093/work:225

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