Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.5
Copyright © 2004 by Project HOPE

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Use Of Medicare Claims Data To Monitor Provider-Specific Performance Among Patients With Severe Chronic Illness

¹ John Wennberg is director of the Center for the Evaluative Clinical Sciences and the Peggy Y. Thomson Professor for Evaluative Clinical Sciences at Dartmouth Medical School in Hanover, New Hampshire.
² Elliott Fisher is codirector of the Veterans Affairs (VA) Outcomes Group, VA Medical Center, in White River Junction, Vermont.
³ Thérèse Stukel is a senior scientist and research director at the Institute for Clinical Evaluative Sciences in Toronto, Ontario.
⁴ Sandra Sharp is a research associate at the Center for the Evaluative Clinical Sciences, Dartmouth Medical School.

^*Corresponding author.

Abstract

This study illustrates that Medicare claims can be used to measure population-based, provider-specific rates of resource inputs, utilization, and Medicare spending. The target populations are seventy-seven cohorts of chronically ill Medicare enrollees who received most of their care from seventy-seven well-known U.S. hospitals. Striking variations are documented in resource inputs and use of services during the last six months of life. The patterns of care seen in the progression of chronic illness correlate highly with care received during previous periods. We believe that hospital-specific measures can be helpful in identifying providers with acceptable quality indices who are also relatively efficient in managing chronic illness.

Key Words: Chronic Care, Hospitals, Quality Of Care, Variations

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