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Tuesday, November 26, 2013

Buckshot: the continuing randomness of U.S. healthcare "value"

I've been doing summary reporting on selected annual HEDIS outcomes across the life of this blog. See my 20102011, and 2012 posts (scroll down in any of them). A salient example from 2010:

HEDIS deploys two proxies which combine to connote value: "quality" (y axis) and "RRUs" (Relative Resource Units, the "cost" analog). As I observed in 2010,
Zero apparent linear "Pearson-R" relationship between cost and quality of outcomes (albeit via their summary "quality vs. cost" proxy scales). The foregoing plot addresses cardiovascular disease, but the scattergrams in the report illustrating other major chronic conditions (hypertension, diabetes, COPD) evince the very same random buckshot patterns. My red rectangle upper left quadrant annotation above is meant to focus on the question this begs of me: are we, consequently, paying too much? What is it about the "above average quality/below average cost" segment that we might discern were we able to "peel the onion back" in search of relevant causal correlates? Is use of HIT a factor? And/or other organizational factors? ( The NCQA report is silent on such implications).
Nothing has changed materially. Below, some selected scatterplots from the 2013 HEDIS Annual Report (pdf).

Groundhog Day. Payor doesn't matter. Major chronic dx doesn't matter. Buckshot.

Below, a graphic of a different (albeit related) sort. from the OECD 2013 report "Health at a Glance 2013."

The outlier U.S. Pay double, get less.

NYeC 2013 Wrap-up

On November 14-15, NYeC held its third annual Digital Health Conference. This year’s conference was the biggest yet with more than 1100 attendees, 70 speakers, and 15 break-out sessions. Top level health IT professionals, CIOs, CMIOs, venture capitalists, entrepreneurs, academics, and a multitude of vendors gathered to discuss and learn about the latest thinking and innovation in the Health IT ecosystem. Two nationally-known experts on the power of data and analytics gave keynote addresses: George Halvorson, Chairman of Kaiser Permanente and Jim Messina, National Director of Organizing for Action and Campaign Manager for President Obama's re-election campaign. Both provided provocative and unique insights on the power of data analytics to significantly improve patient care and transform care delivery.
Hot discussion topics at the conference included HIE trends, the importance of interoperability standards on driving Health IT innovation, and the value of empowering consumers with their own health information as a tool to advance healthcare.
Thanks to all of our sponsors, partners, and speakers who helped to make this year's Digital Health Conference a resounding success.

LOL. There I am, front row in the Grand Ballroom at 1:52, blogging away into my Mac Air.



More to come...

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