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Report: High-quality health care can be affordable Posted: September 12th, 2012

By Maryalene LaPonsie

Maryalene LaPonsie has been writing professionally for more than a decade on topics including education, insurance and personal finance. She holds a Bachelor's Degree in Political Science from Western Michigan University.

High-quality health care doesn't have to cost a bundle. There is considerable variation in the cost of health care across the country, and the best care can be up to 14 percent more affordable than the national average, according to a recent report.

The report looked at the data from nearly 250,000 U.S. physicians working with commercially insured patients. It considered care for both common chronic conditions as well as major medical procedures.

Episode costs were reviewed for the following conditions and procedures, among others:

  • Asthma
  • Diabetes
  • Hypertension
  • Cardiac catheterization
  • Arthroscopic knee surgery
  • Vaginal childbirth

For major medical procedures, per episode costs varied 2.5 times while there was a 15-fold variation in the cost of episode care for chronic conditions.

Overall, the study found care provided by physicians receiving both quality and cost-efficiency designations had a price that was, on average, 14 percent less than the national average. In addition, there did not seem to be any correlation between average costs and the average quality of care. In other words, the study suggests high-cost areas don't necessarily provide higher quality care.

Recommendations for health insurance plans

The findings were published in the September issue of the journal Health Affairs and come from a study completed by UnitedHealth Group's Center for Health Reform and Modernization. UnitedHealth Group is the parent company of UnitedHealthcare, a medical insurance provider.

Based upon the study's conclusions, the center has recommended four strategies be implemented by health care organizations and health insurance plans. They are:

  • Improve quality measures to better capture changes in patient health
  • Expand data sharing
  • Customize payment reform to adopt 'performance-based contracting' which ties medical insurance payments to patient outcomes
  • Add new tools and resources to help doctors and hospitals

While these strategies target physicians and health care providers, if implemented, they could have the potential to impact consumers as well. Affordable health insurance may be one result if insurance companies are able to reduce the overall cost of care.

However, changes to medical insurance payment procedures could also affect consumer access to certain physicians if health insurance plans decide to limit in-network providers to those meeting certain performance measures.

For now, the Health Affairs article highlights the discrepancy in health care costs across the United States. It remains to be seen whether its findings will result in any lasting changes to health insurance plans and the health care payment system.