Current Weather
The Spy FM

Insurer’s Files Show Big Cost Differences For Same Illnesses

Filed by KOSU News in Business.
September 5, 2012

Yes, we’ve seen this before: a study showing large spending disparities to treat similar ailments and little if any link between expenditure and effectiveness.

What’s different about a new analysis is the patients.

Many reports on cost and quality disparity (the best known is the Dartmouth Atlas of Health Care) are based on data from the government’s Medicare program for seniors. But one published in the latest issue of Health Affairs focuses on care provided by nearly 250,000 doctors treating non-elderly patients insured by UnitedHealthcare from 2006 through part of 2009.

Some of the cost variations are startling. For treating a basic asthma episode, cases in the 10th percentile of distribution cost $98 each while those in the 90th percentile the cost was $1,535 per case. As usual, the study’s authors, all of whom work for UnitedHealthcare or a sister company, attempted to adjust for case severity. That means you can’t explain the difference by saying expensive patients were 15 times sicker than the cheap ones.

Migraine sufferers in the 10th percentile got treated for $94 while those in the 90th percentile cost the system $2,006. Expense for treating high blood pressure ran from $149 to $1,469 per episode.

The cost disparity for major procedures was smaller. But the dollars were larger. Bills for implanting a drug-coated coronary artery stent were $16,092 in the 10th percentile and $36,487 in the 90th — more than twice as much. Uncomplicated baby deliveries ranged from $6,149 to $12,090.

Like previous studies based on Medicare claims, the study also found wide variation in costs in different geographical areas. But bigger price tags didn’t buy better outcomes. “We found essentially no correlation between average costs and the measured level of care quality across markets,” the authors wrote.

The researchers studied doctors who had already been identified as providing higher-quality care, demonstrating large variability even within that group. However, some who received good scores for both quality and efficiency delivered care costing about 14 percent less compared with that of other doctors.

“Changing incentives through payment reforms could help to improve performance, but providers are at different stages of readiness for such reforms,” the authors conclude.

Translation: The medical value equation is still far from being solved. [Copyright 2012 Kaiser Health News]

Leave a Reply

10AM to 11PM On Point

On Point

On Point unites distinct and provocative voices with passionate discussion as it confronts the stories that are at the center of what is important in the world today. Leaving no perspective unchallenged, On Point digs past the surface and into the core of a subject, exposing each of its real world implications.

Listen Live Now!

11AM to 12PM The Story

The Story

The Story with Dick Gordon brings the news home through first-person accounts. The live weekday program is passionate, personal, immediate and relevant to listeners, focusing on the news where it changes our lives, causes us to stop and rethink, inspires us.

View the program guide!

12PM to 1PM Fresh Air

Fresh Air

This one-hour program features Terry Gross' in-depth interviews with prominent cultural and entertainment figures, as well as distinguished experts on current affairs and news.

View the program guide!

Upcoming Events in your area (Submit your event today!)

Streaming audio and podcasts

Stream KOSU on your smartphone

Phone Streaming

SmartPhone listening options on this page are intended for many iPhones, Blackberries, etc. with low-cost software applications available to listen to our full-time web streams, both News on KOSU-1 and Classical on KOSU-2.

Learn more about our complete range of streaming services

We're perfecting the patient experience - Stillwater Medical Center