Health Affairs, doi: 10.1377/hlthaff.27.2.w123
(Published online February 12, 2008)
© 2008 by Project HOPE
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Variations In Hospital Resource Use For Medicare And Privately Insured Populations In California

Laurence C. Baker 1*, Elliott S. Fisher 2, John E. Wennberg 3

1 Laurence Baker is a professor of health research and policy at Stanford University in Stanford, California.
2 Elliott Fisher is a professor of medicine and of community and family medicine, Dartmouth Medical School, and director of the Center for Health Policy Research at the Dartmouth Institute for Health Policy and Clinical Practice, in Hanover, New Hampshire.
3 John Wennberg is the Peggy Y. Thomson Professor in the Evaluative Clinical Sciences at Dartmouth, and director emeritus of the institute.

*Corresponding author.

  Abstract

The amount of resources used in the care of chronically ill Medicare fee-for-service (FFS) patients varies widely across hospitals. We studied variations across California hospitals in hospital resource use for chronically ill patients covered by Medicare health maintenance organizations (HMOs) and private insurers and found substantial variation in all of the coverage groups studied. Resource-use measures based on Medicare FFS data often reflect patterns evident for other payers. Previous estimates of savings if the most resource-intensive hospitals more closely resembled less resource-intensive hospitals, based on just Medicare FFS spending, could underestimate possible savings when other payers are taken into account. [Health Affairs 27, no. 2 (2008): w123-w134 (published online 12 February 2008; 10.1377/hlthaff.27.2.w123)]

Key Words: Business Of Health, Hospitals, Medicare, Health Spending, State/Local Issues - California


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