Health Reform from Transition Central

A Health Reformer’s Online Diary | Ken Terry | November 17, 2008

A blog post suggests that  the U.S. healthcare system can improved by organizing providers,  improving quality,  reforming reimbursements, and researching cost-effectiveness.

As to cost-effectiveness research, Health Reformer says,  “…. have Medicare look not only at the clinical effectiveness of tests and treatments, but also at their cost-effectiveness–an idea that has been banished from American political discourse since the demise of the U.S. Office of Technology Assessment in the early ‘90s.”

You can check out several excellent reports on the cost-effectiveness of health care from the OTA archive:

1994 report, Identifying Health Technologies that Work – Searching for Evidence,  is a comprehensive update about what works.   Chapter 6, a history of the federal role in health technology assessment, may be of current interest.

A 1988 report, The Quality of Medical Care: Information for Consumers,  is a great compendium on how medical care can be evaluated.  It combines a conceptual framework,  dimensions to consider, and an analysis of possible indicators of the quality of care provided by physicians and hospitals.

A 1986 report, Payment for Physician Services: Strategies for Medicare, lays out a relevant process for analyzing how we pay for heathcare (even though the policy context is dated).  It evaluates some innovative payment methods, for example, bundling services into a package that is paid for at a flat rate or paying for a greater scope of services by capitation.