The Association Between Provider Price and Complication Rates for Outpatient Surgical Services 1,2 Christopher Whaley, Ph.D. 1 2 RAND Corporation, Santa Monica, CA, USA; School of Public Health, University of California, Berkeley, Berkeley, CA, USA. services, procedure- and provider-level prices are associ- BACKGROUND: Wide variations exist in price and quality ated with modest increased rates of complication rates. for health-care services, but the link between price and quality remains uncertain. KEY WORDS: provider price; provider quality. OBJECTIVE: This paper used claims data from a large commercially insured population to assess the associa- J Gen Intern Med 33(8):1352–8 tion between both procedure- and provider-level prices DOI: 10.1007/s11606-018-4506-7 and complication rates for three common outpatient sur- © Society of General Internal Medicine 2018 gical services. DESIGN: This is a retrospective cohort study. SETTING: The study used medical claims data from com- mercial health plans between 2009 and 2013 for three outpatient surgical services—joint arthroscopy, cataract INTRODUCTION surgery, and colonoscopy. The US health-care system exhibits substantial variation in MAIN MEASURES: For each procedure, price was 1–3 4 5,6 7–9 prices, spending, utilization, and outcomes. The link assessed as the sum of patient, employer, and insurer between variations in price and quality remains
Journal of General Internal Medicine – Springer Journals
Published: Jun 4, 2018
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