HealthDay News — According to a study published in the Journal of the American Medical Association, health care costs can be reduced by using a multifaceted value-driven outcomes tool that identifies variability in costs and outcomes.

In an uncontrolled observational study, Vivian Lee, MD, PhD, from the University of Utah in Salt Lake City, and colleagues measured the association between a value-driven outcomes tool that allocates costs of care and quality measures to individual patient encounters and cost reduction and health outcome optimization. Data were reviewed for 1.7 million total patient visits, including 34,000 inpatient discharges.

The researchers found that professional costs accounted for 24.3 and 41.9% of total costs for inpatient episodes and outpatient visits, respectively. For Medicare severity diagnosis related groups with the highest total direct costs, cost variability was highest for postoperative infection and sepsis, and lowest for organ transplantation.

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For total joint replacement, a composite quality index was 54 and 80% at baseline and 1 year into the implementation, respectively (P<.001); mean direct costs were 7% lower in the implementation year and 11% lower in the post-implementation year compared with the baseline year.

“There may be benefit for individual physicians to understand actual care costs (not charges) and outcomes achieved for individual patients with defined clinical conditions,” the authors write.

Several authors disclosed ties to the medical technology industry.


Lee VS, Kawamoto K, Hess R, et al. Implementation of a Value-Driven Outcomes Program to Identify High Variability in Clinical Costs and Outcomes and Association With Reduced Cost and Improved Quality. JAMA. 2016;316(10):1061-72. doi:10.1001/jama.2016.12226.

Porter ME, Lee TH. From Volume to Value in Health Care: The Work Begins. JAMA. 2016;316(10):1047-8. doi:10.1001/jama.2016.11698.

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