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Variation in Health Care Spending: Target Decision Making, Not Geography (2013)

Chapter: Appendix B: Acronyms and Abbreviations

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Suggested Citation:"Appendix B: Acronyms and Abbreviations." Institute of Medicine. 2013. Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press. doi: 10.17226/18393.
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Appendix B

Acronyms and Abbreviations

AAMC Association of American Medical Colleges
ACA Affordable Care Act
ACO accountable care organization
ACS American Community Survey
 
BCBSMA Blue Cross Blue Shield of Massachusetts
 
CBO Congressional Budget Office
CBSA core based statistical area
CHD coronary heart disease
CHF congestive heart failure
CMS Centers for Medicare & Medicaid Services
COPD chronic obstructive pulmonary disease
CPT current procedural terminology
 
DME direct medical education or durable medical equipment
DRG diagnosis-related group
DSH disproportionate share hospital
 
FHS Fairview Health Services
FISMA Federal Information Security and Management Act of 2002
FQHC federally qualified health center
 
GDP gross domestic product
Suggested Citation:"Appendix B: Acronyms and Abbreviations." Institute of Medicine. 2013. Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press. doi: 10.17226/18393.
×
GPCI geographic practice cost index
 
HCC hierarchical condition category
HEDIS Health Care Effectiveness Data and Information Set
HHS U.S. Department of Health and Human Services
HIT health information technology
HMO health maintenance organization
HRR hospital referral region
HRSA Health Resources and Services Administration
HSA hospital service area
 
IHA integrated health association
IME indirect medical education
IOM Institute of Medicine
IQI inpatient quality composite indicator
 
MedPAC Medicare Payment Advisory Commission
MSA metropolitan statistical area
 
NCQA National Committee for Quality Assurance
 
OIG U.S. Office of the Inspector General
 
PCMH primary care medical home or patient-centered medical home
PCP primary care physician
PDI pediatric quality indicator
PGPD physician group practice demonstration
PHE precision health economics
PPO preferred provider organization
PQI prevention quality indicator
PSI patient safety indicator
PYE partial-year enrollment
 
RVU relative value unit
RxHCC prescription drug hierarchical condition category
 
SGR sustainable growth rate
 
VBP value-based purchasing
Suggested Citation:"Appendix B: Acronyms and Abbreviations." Institute of Medicine. 2013. Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press. doi: 10.17226/18393.
×
Page 129
Suggested Citation:"Appendix B: Acronyms and Abbreviations." Institute of Medicine. 2013. Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press. doi: 10.17226/18393.
×
Page 130
Next: Appendix C: Summary of Empirical Modeling Methodology »
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Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain budgets at all levels of government and threaten the solvency of Medicare, the nation's largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger.

Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less.

Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients.

Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.

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