Illustrating potential efficiency gains from using cost-effectiveness evidence to reallocate medicare expenditures

Value in Health

Volumn 16, Issue 4, 2013, Pages 629-638

  Chambers, James D ^a,b   Lord, Joanne ^a   Cohen, Joshua T ^b   Neumann, Peter J ^b   Buxton, Martin J ^a  

^a BRUNEL UNIVERSITY   (United Kingdom)

^b TUFTS MEDICAL CENTER   (United States)

Author keywords

cost effectiveness; disinvestment; Medicare; resource allocation

Indexed keywords

ARTICLE; COST EFFECTIVENESS ANALYSIS; DATA BASE; HEALTH CARE COST; HUMAN; INVESTMENT; MEDICAID; MEDICAL LITERATURE; MEDICARE; POPULATION; PRIORITY JOURNAL; QUALITY ADJUSTED LIFE YEAR; REIMBURSEMENT; RESOURCE ALLOCATION; TECHNOLOGY;

COST-BENEFIT ANALYSIS; EFFICIENCY; HEALTH CARE RATIONING; HEALTH POLICY; HUMANS; INSURANCE COVERAGE; MEDICARE; QUALITY-ADJUSTED LIFE YEARS; UNITED STATES;

EID: 84879409751     PISSN: 10983015     EISSN: 15244733     Source Type: Journal    
DOI: 10.1016/j.jval.2013.02.011     Document Type: Article

References (41)

1. S.P. Keehan, A.M. Sisko, and C.J. Truffer National health spending projections through 2020: economic recovery and reform drive faster spending growth Health Aff (Millwood) 30 2011 1594 1605
2. Organisation for Economic Co-operation and Development. OECD Health Data 2010: How Does the United States Compare? Paris, France: OECD Publishing
3. Davis K, Schoen C, Stremikis K. Mirror, mirror on the wall. How the performance of the US health care system compares internationally. 2010 update. 2010. Available from: http://www.commonwealthfund.org/∼/media/Files/ Publications/Fund%20Report/2010/Jun/1400-Davis-Mirror-Mirror-on-the-wall-2010. pdf. [Accessed June 8, 2012].
4. S. Bryan, S. Sofaer, T. Siegelberg, and M. Gold Has the time come for cost-effectiveness analysis in US health care? Health Econ Policy Law 4 Pt 4 2009 425 443
5. Centers for Medicare & Medicaid Services. National health expenditure data. Available from: https://www.cms.gov/NationalHealthExpendData/downloads/ tables.pdf. [Accessed June 8, 2012].
6. T.G. Bentley, R.M. Effros, K. Palar, and E.B. Keeler Waste in the U.S. health care system: a conceptual framework Milbank Q 86 2008 629 659
7. E.S. Fisher, D.E. Wennberg, and T.A. Stukel The implications of regional variations in Medicare spending, part 1: the content, quality, and accessibility of care Ann Intern Med 138 2003 273 287
8. A. Garber, D.P. Goldman, and A.B. Jena The promise of health care cost containment Health Aff (Millwood) 26 2007 1545 1547
9. United States General Accounting Office. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives. Medicare: Divided Authority for Policies on Coverage of Procedures and Devices Results in Inequities. Apr 11, 2003, GAO-03-175. Available from: http://www.gao.gov/assets/240/237841.pdf. [Accessed June 8, 2012].
10. D.M. Berwick, and A.D. Hackbarth Eliminating waste in US health care JAMA 307 2012 1513 1516
11. Medicare Program; Revised Process for Making Medicare National Coverage Determinations; Notice of proposed rulemaking, 68 Federal Register 187 (26 September 2003), pp 55634-41
12. Centers for Medicare & Medicaid Services. Guidance for the public, industry and CMS staff: factors CMS considers in opening a national coverage determination. Available from: http://www.cms.gov/medicare-coverage-database/ details/medicare-coverage-document-details.aspx?MCDId=6&McdName= Factors+CMS+Considers+in+Opening+a+National+Coverage+Determination& mcdtypename=Guidance+Documents&MCDIndexType=1&bc=BAAIAAAAAAAA&. [Accessed June 8, 2012].
13. J.D. Chambers, P.J. Neumann, and M.J. Buxton Does Medicare have an implicit cost-effectiveness threshold? Med Decis Making 30 2010 E14 E27
14. J.D. Chambers, S. Morris, P.J. Neumann, and M.J. Buxton Factors predicting Medicare national coverage: an empirical analysis Med Care 50 2012 249 256
15. U.S. National Library of Medicine. PubMed: U.S. National Library of Medicine, National Institutes of Health. Available from: http://www.ncbi.nlm. nih.gov/pubmed/. [Accessed June 8, 2012].
16. CEA Registry. Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry. Available from: http://www.cearegistry.org. [Accessed June 8, 2012].
17. Health Economic Evaluation Database. Health Economic Evaluation Database. Available from: http://www3.interscience.wiley.com/cgi-bin/mrwhome/114130635/ HOME. [Accessed June 8, 2012].
18. Centre for Reviews and Dissemination. National Health Service-Economic Evaluation Database. Available from: http://www.crd.york.ac.uk/crdweb/. [Accessed June 8, 2012].
19. Erickson P, Wilson R, Shannon I. Years of healthy life. Healthy People 2000 Stat Notes 1995;7:1-15.
20. Organisation for Economic Co-operation and Development. Purchasing power parity (PPP) statistics. 2010. Available from: http://www.oecd.org/dataoecd/61/ 56/39653523.xls. [Accessed February 27, 2013].
21. U.S. Bureau of Labor Statistics. Measuring Price Change for Medical Care in the CPI. Available from: http://www.bls.gov/cpi/cpifact4.htm. [Accessed June 8, 2012].
22. Centers for Medicare & Medicaid Services. Research, statistics, data and systems: limited data sets. Available from: http://www.cms.gov/ LimitedDataSets/01-Overview.asp#TopOfPage. [Accessed June 8, 2012].
23. M. Johannesson, and M.C. Weinstein On the decision rules of cost-effectiveness analysis J Health Econ 12 1993 459 467
24. J. Lord, G. Laking, and A. Fischer Health care resource allocation: is the threshold rule good enough? J Health Serv Res Policy 9 2004 237 245
25. D.D. Matlock, P.N. Peterson, and P.A. Heidenreich Regional variation in the use of implantable cardioverter-defibrillators for primary prevention: results from the National Cardiovascular Data Registry Circ Cardiovasc Qual Outcomes 4 2011 114 121
26. Y. Song, J.S. Skinner, and J.P.W. Bynum Regional variations in diagnostic practices New Engl J Med 363 2010 45 53
27. D. Greenberg, C. Earle, and C.H. Fang When is cancer care cost-effective? A systematic overview of cost-utility analyses in oncology J Natl Cancer Inst 102 2010 82 88
28. K.A. Phillips, and J.L. Chen Impact of the U.S. panel on cost-effectiveness in health and medicine Am J Prev Med 22 2002 98 105
29. D. Greenberg, and P.J. Neumann Is it cost-effective? It depends on who you ask B. Rosen, A. Israeli, S. Shortell, Improving Health and Healthcare. Who is Responsible? Who is Accountable? Tel Hashomer, Israel: The Israel National Institute for Health Policy Research 2011
30. M.C. Weinstein, and J.A. Skinner Comparative effectiveness and health care spending - implications for reform N Engl J Med 362 2010 460 465
31. J. Daly, A.P. Sindone, and D.R. Thompson Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review Prog Cardiovasc Nurs 17 2002 8 17
32. J.A. Parkosewich Cardiac rehabilitation barriers and opportunities among women with cardiovascular disease Cardiol Rev 16 2008 36 52
33. R.J. Thomas Cardiac rehabilitation/secondary prevention programs: a raft for the rapids: why have we missed the boat? Circulation 116 2007 1644 1646
34. Congressional Budget Office. Our processes. Available from: http://www.cbo.gov/about/our-processes [Accessed June 8, 2012]
35. Centers for Medicare & Medicaid Services. CMS's Office of the Actuary. Available from: http://www.cms.gov/About-CMS/Agency-Information/ CMSLeadership/Office-OACT.html [Accessed June 8, 2012].
36. P.S. Keenan, P.J. Neumann, and K.A. Phillips Biotechnology and Medicare's new technology policy: lessons from three case studies Health Aff (Millwood) 25 2006 1260 1269
37. S. Griffin, K. Claxton, S. Palmer, and M.J. Sculpher Dangerous omissions: the consequences of ignoring decision uncertainty Health Econ 29 2011 212 224
38. J. Coast Is economic evaluation in touch with society's health values? BMJ 329 2004 1233 1236
39. P. Dolan, and R. Cookson A qualitative study of the extent to which health gain matters when choosing between groups of patients Health Policy 51 2000 19 30
40. E. Nord, J. Richardson, and A. Street Maximizing health benefits vs egalitarianism: an Australian survey of health issues Soc Sci Med 41 1995 1429 1437
41. P.A. Ubel Pricing Life: Why It's Time for Health Care Rationing 2001 Cambridge, MA: MIT Press