A study published in JAMA Internal Medicine found that higher spending on physicians doesn’t lead to better outcomes for patients who have been hospitalized.
The study included data from a little more than 72,000 physicians over 1,324,000 hospitalizations of Medicare beneficiaries.
The authors found that, perhaps unsurprisingly, spending variation is greater among than physicians than among hospitals.
They said the data “suggest that not only does physician spending vary substantially even within the same hospital, but also that higher-spending physicians do not reliably achieve better patient outcomes.”
The authors point out that many payment-reform and value-based care efforts are targeted to hospitals that, it is assumed, can help influence physician behavior. They suggest that this targeting should also directly include physicians, to help cut costs.
“Our findings suggest that higher-spending physicians may be able to reduce resource use without compromising patient outcomes. Policy interventions that target physicians within hospitals (e.g., physician-level pay-for-performance programs and reporting of how resource use of each physician compares with other physicians within the same hospital) should be developed and evaluated.”
“Among both hospitalists and general internists, physicians with higher spending per hospitalization had no detectable differences in 30-day mortality or readmissions compared with lower-spending physicians within the same hospital. Given larger variation in spending across physicians than across hospitals, policies that target physicians within hospitals may be more effective in reducing wasteful spending than policies focusing solely on hospitals.”
To read the JAMA piece, please hit this link.
