Health Affairs

This Article Figures Only Full Text (HTML) Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when Comments are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (21) Citing Articles via Google Scholar Google Scholar Articles by Birkmeyer, J. D. Articles by Wennberg, D. E. Search for Related Content PubMed PubMed Citation Articles by Birkmeyer, J. D. Articles by Wennberg, D. E. Related Collections Hospitals Health Spending

DataWatch

Will Volume-Based Referral Strategies Reduce Costs Or Just Save Lives?

John D. Birkmeyer, Jonathan S. Skinner and David E. Wennberg

Although recent policy initiatives aimed at concentrating selected surgical procedures in high-volume hospitals may reduce mortality, their economic implications have not been considered fully. From the hospital perspective, the primary effect of these policies will be to redistribute surgical profits to bigger centers. From the payer perspective, prices paid for procedures will likely increase in some geographic areas. From the societal perspective, how these policies will affect the true cost of providing surgical care is uncertain, but use of discretionary procedures will likely increase. For these reasons, the primary argument for volume-based referral strategies should be improving quality, not reducing costs.

                      What's this?

This article has been cited by other articles:

				K. Kronebusch Assessing Changes in High-Volume Hospital Use: Hospitals, Payers, and Aggregate Volume Trends Med Care Res Rev, April 1, 2009; 66(2): 197 - 218. [Abstract] [PDF]

				B. D. Kozower, G. J. Stukenborg, C. L. Lau, and D. R. Jones Measuring the Quality of Surgical Outcomes in General Thoracic Surgery: Should Surgical Volume Be Used to Direct Patient Referrals? Ann. Thorac. Surg., November 1, 2008; 86(5): 1405 - 1408. [Full Text] [PDF]

				W. B. Weeks, A. N. West, A. E. Wallace, R. E. Lee, D. C. Goodman, J. B. Dimick, and J. P. Bagian Reducing Avoidable Deaths Among Veterans: Directing Private-Sector Surgical Care to High-Performance Hospitals Am J Public Health, December 1, 2007; 97(12): 2186 - 2192. [Abstract] [Full Text] [PDF]

				A. B. Nattinger, P. W. Laud, R. A. Sparapani, X. Zhang, J. M. Neuner, and M. A. Gilligan Exploring the Surgeon Volume Outcome Relationship Among Women With Breast Cancer Arch Intern Med, October 8, 2007; 167(18): 1958 - 1963. [Abstract] [Full Text] [PDF]

				L. G. Glance, T. M. Osler, D. B. Mukamel, and A. W. Dick Estimating the potential impact of regionalizing health care delivery based on volume standards versus risk-adjusted mortality rate Int. J. Qual. Health Care, August 1, 2007; 19(4): 195 - 202. [Abstract] [Full Text] [PDF]

				R. E. Herzlinger and R. Parsa-Parsi Consumer-Driven Health Care: Lessons From Switzerland JAMA, September 8, 2004; 292(10): 1213 - 1220. [Abstract] [Full Text] [PDF]

				A. J. Epstein, S. S. Rathore, K. G. M. Volpp, and H. M. Krumholz Hospital percutaneous coronary intervention volume and patient mortality, 1998 to 2000: Does the evidence support current procedure volume minimums? J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1755 - 1762. [Abstract] [Full Text] [PDF]

				T. J. Smith, B. E. Hillner, and H. D. Bear Taking Action on the Volume-Quality Relationship: How Long Can We Hide Our Heads in the Colostomy Bag? J Natl Cancer Inst, May 21, 2003; 95(10): 695 - 697. [Full Text] [PDF]