Comments on: Hospital Costs And Quality: Amitabh Chandra’s View http://healthaffairs.org/blog/2009/06/11/hospital-costs-and-quality-amitabh-chandras-view/?utm_source=rss&utm_medium=rss&utm_campaign=hospital-costs-and-quality-amitabh-chandras-view The Policy Journal of the Health Sphere Thu, 24 May 2012 07:58:29 +0000 hourly 1 By: acavale http://healthaffairs.org/blog/2009/06/11/hospital-costs-and-quality-amitabh-chandras-view/comment-page-1/#comment-25953 acavale Fri, 12 Jun 2009 02:27:30 +0000 http://healthaffairs.org/blog/?p=1333#comment-25953 I find both studies (yours and Jha's) very interesting and confirming my anecdotal experiences with regard to hospital costs and quality of care. However, both studies leave room for interpretation, and hence can be manipulated to suit various political ideologies. Therefore it would be beneficial if you could clarify certain details: 1) When speaking about hospital costs, is Medicare payment cost more important to measure as compared to costs incurred by hospitals to provide certain services? Because if this is true, then the real culprit is the flawed Medicare reimbursement formulas which encourage hospitals' practices of churning out as many high DRG patients as possible. As you know, hospital operating costs have steadily climbed over the years, while Medicare payment rates have been flat over the past 8 years. 2) When you talk about "efficiency frontier" were you able to define specific processes such hospitals are able to do better for less cost? 3) And were you able to identify the areas where the less cost-efficient hospitals were spending their dollars as compared to the more efficient ones? Were the efficiencies/inefficiencies mainly in terms of human/labor costs or were they related to use of technology/procedures? I find both studies (yours and Jha’s) very interesting and confirming my anecdotal experiences with regard to hospital costs and quality of care. However, both studies leave room for interpretation, and hence can be manipulated to suit various political ideologies.

Therefore it would be beneficial if you could clarify certain details:

1) When speaking about hospital costs, is Medicare payment cost more important to measure as compared to costs incurred by hospitals to provide certain services? Because if this is true, then the real culprit is the flawed Medicare reimbursement formulas which encourage hospitals’ practices of churning out as many high DRG patients as possible. As you know, hospital operating costs have steadily climbed over the years, while Medicare payment rates have been flat over the past 8 years.

2) When you talk about “efficiency frontier” were you able to define specific processes such hospitals are able to do better for less cost?

3) And were you able to identify the areas where the less cost-efficient hospitals were spending their dollars as compared to the more efficient ones? Were the efficiencies/inefficiencies mainly in terms of human/labor costs or were they related to use of technology/procedures?

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