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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). 

 

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