Cost & Efficiency
The Situation: In February 2013, CMS granted a waiver enabling the state of Ohio to move up to 30,000 uninsured adults in Cuyahoga County to a new health care coverage program called CarePlus by the end of 2013. Several AF4Q partners in the Better Health Greater Cleveland Alliance enrolled 28,294 uninsured patients in CarePlus, with a goal of providing better access, better care, and better outcomes, but with costs lower than those CMS estimated as “budget neutral.”
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While health care costs in the United States often are a mystery, they remain of great public interest, and are the focus of many regional and national health care quality improvement initiatives. Measuring cost and efficiency present challenges, and significantly bending the cost curve remains elusive. Most AF4Q communities are at the beginning of the process of reporting cost data, convening disparate stakeholders to find consensus on goals and definitions. Demystifying the cost question will be the first step toward solving it—and may reveal that health care doesn’t cost too much at all, it’s only that we’re spending our money on the wrong things. See how we are Defining the Problem here.
If you need a new pair of sandals, any smart shopper can find out if the neighborhood shoe store is more or less expensive than the department store downtown. A small amount of research can help a consumer compare prices on just about any good or service in America. The exception: health care.
Health care costs in America are such a mystery that often even doctors and most people who work in hospitals or clinics don’t know what they’re charging. In a new commentary, Robert Graham, MD, National Program Director for AF4Q, and Michael W. Painter, JD, MD, Senior Program Officer at the Robert Wood Johnson Foundation, offer their thoughts on the complex landscape of measuring health care cost and determining price in America.
Read More Here.