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Cost and Efficiency

Cost and Efficiency

Resource use measures are measures that capture the amount or frequency of health services applied to a population or event (e.g., procedures, encounters). A resource use measure may apply a dollar amount (e.g., allowable charges, paid amounts, or standardized prices) to a resource unit. As health care expenditures continue to grow, it is crucial to understand how resources are utilized to maximize quality in the health care system. Health care cost measurement continues to be a critical component in assessing the United States (U.S.) health care system. Measures in the Cost, Resource Use, and Efficiency portfolio are essential to evaluate the efficiency of care (i.e., higher quality, lower cost) and improve value through changes in practice. Improving U.S. health system efficiency can simultaneously reduce cost growth and improve the quality of care provided.

This committee considers measures that focus on total health care spending for a health care service or group of services associated with a specified patient population, time period, and/or unit of clinical accountability. Measures in this topic area include admission, readmission, and emergency department utilization. Others include broadly focused measures, such as per capita measures, which address total health care spending or resource use per person, and narrowly focused measures, such as measures dealing with the health care spending or resource use of an individual procedure (e.g., a hip replacement). 

 

Committee Roster

Measures

Project

Measures

CBE ID Title Steward New / Maintenance Previous Endorsement Cycle Next Maintenance Cycle Endorsement Status
3510 Screening/Surveillance Colonoscopy Centers for Medicare & Medicaid Services Maintenance Spring 2019 Spring 2025 Endorsed
3512 Knee Arthroplasty Centers for Medicare & Medicaid Services Maintenance Spring 2019 Spring 2025 Endorsed
3561 Medicare Spending Per Beneficiary – Post Acute Care Measure for Inpatient Rehabilitation Facilities Centers for Medicare & Medicaid Services Maintenance Spring 2020 Spring 2026 Endorsed
3562 Medicare Spending Per Beneficiary – Post Acute Care Measure for Long-Term Care Hospitals Centers for Medicare & Medicaid Services Maintenance Spring 2020 Spring 2026 Endorsed
3575 Total Per Capita Cost (TPCC) Centers for Medicare & Medicaid Services Maintenance Spring 2020 Fall 2024 Endorsed
3623 Elective Primary Hip Arthroplasty Measure Centers for Medicare & Medicaid Services Maintenance Spring 2022 Spring 2026 Endorsed
3625 Non-Emergent Coronary Artery Bypass Graft (CABG) Measure Centers for Medicare & Medicaid Services Maintenance Spring 2022 Spring 2026 Endorsed
3626 Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels Measure Centers for Medicare & Medicaid Services Maintenance Spring 2022 Spring 2026 Endorsed
2414 Pediatric Lower Respiratory Infection Readmission Measure Center of Excellence for Pediatric Quality Measurement Maintenance Fall 2023 Endorsement Removed
2393 Pediatric All-Condition Readmission Measure Center of Excellence for Pediatric Quality Measurement Maintenance Fall 2023 Endorsement Removed
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