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An AgendA for ChAnge Improving Quality and Curbing Health

An AgendA for ChAnge Improving Quality and Curbing Health

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Published by: api-8489362 on Mar 04, 2009
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01/29/2013

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Improvi Quai a Curi Hah Car Spi:Opporuiis or h Corss a h Oama Amiisraio
 A Dartmouth Atlas White Paper 
Medicare Spending per Beneciary, 2005
$8,600 to $14,360$7,800 to $8,600$7,200 to $7,800$6,600 to $7,200$5,280 to $6,600Not Populated
 
RISIng HeAltH CARe COStS
are a major challenge to the Americaneconomy, particularly at a time of deepening recession and a renewedcommitment to extend coverage to the uninsured. Dartmouth Atlasresearch on geographic differences in health care delivery and spending
points to an opportunity to achieve signicant savings in health care costs
without compromising health care quality and outcomes. More spendingand more utilization do not translate into improved life expectancy forthose with chronic illness. The differences in the use of discretionary
surgery do not reect differences in patient preferences and informed
patient choice. This paper discusses opportunities for Congress and theObama Administration to address key shortcomings in our health caresystem that result in unwarranted geographic variation and uncontrolledgrowth in health care spending. Success in this effort will not only improvethe quality of care, it will make it possible to extend coverage to America’suninsured without inducing a major increase in health care spending.
This Dartmouth Atlas White Paper was written by John E. Wennberg,Shannon Brownlee, Elliott S. Fisher, Jonathan S. Skinner and James N.Weinstein.
December 2008
P
refACe
 
ecuiv Summar _____________________________________________________
i - iv
th Prom o Uarra Variaio i Mica Pracic ___________________
1
Ursai Supp-Ssiiv Car _______________________________________
2Implications for Reform ___________________________________________________4
Ruci Ovrus o Supp-Ssiiv Car a Promoi Orai Car __
5Implications for Federal Science Policy ______________________________________6Implications for Physician Workforce Policy __________________________________7Implications for Cost Containment __________________________________________7
Ursai Prrc-Ssiiv Car ___________________________________
8
Ruci Uarra Variaio i Prrc-Ssiiv Car _______________
10Establishing Informed Patient Choice as the Legal Standard __________________10Changing the Standard for Payer Determination of Medical Necessity __________10Establishing Informed Patient Choice in Federal Health Care Systems __________12Implications for Science Policy ____________________________________________12Implications for Physician Workforce Policy _________________________________13Implications for Cost Containment _________________________________________13
Impicaios or ei Covra o Amrica’s Uisur ________________
13Geographic Equity and Regional Markets ___________________________________13Likely Effects of Increasing Coverage on the Overall Cost of Care _____________14
Summar ________________________________________________________________
15
Rrcs _______________________________________________________________
16
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