Assessing Value at U.S. Hospitals

This grant will support the development of an approach for assessing the relative value of care provided in U.S. hospitals. Value will be measured based on the difference between the actual and expected number of “high-value” discharges produced by hospitals, after controlling for health status and sociodemographics, and resources used. A high-value discharge will be defined as one where the patient was discharged alive and was not readmitted within 30 days, and will be adjusted for hospitalwide patient satisfaction. The population studied will be Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia. The team will assess the usefulness of the measurement approach in determining to what extent value changes over time, if hospitals in the same region tend to deliver similar value, and how value varies by health condition within a hospital. This project will advance understanding of how cost and quality measures can be combined to assess health care value. Neither the value measures nor the results of their application would be made public prior to peer review and publication.