New Report Finds Healthcare Cost Drivers Difficult to Control

Onpoint's Karl Finison, Director of Analytic Development, and Katie McGraves-Lloyd, Health Data Analyst, recently collaborated with Blueprint for Health leaders Craig Jones, MD, and Nick Lovejoy and with researchers from the University of Richmond and the College of William and Mary to publish a Blueprint-focused study with Population Health Management. In their article, "Evaluating Health Care Delivery Reform Initiatives in the Face of 'Cost Disease'," the team analyzed five years (2007-2011) of commercial and Medicaid claims data from the Vermont APCD.

The study's goal: to determine per-capita inpatient expenditures, cost per discharge, and cost per inpatient day, as well as to evaluate the proportion of all healthcare expenditures allocated to mental health, maternity care, and surgical and medical services.

The authors found that although the utilization of inpatient services (both by the commercial population and by the Medicaid population) decreased during the study period, cost per discharge (commercial and Medicaid populations) and cost per inpatient (commercial population only) increased considerably. The authors conclude that while healthcare providers increasingly are being assessed on their ability to control healthcare costs while achieving better outcomes, there are many cost drivers that providers simply cannot control. They suggest that health reform initiatives should therefore focus on utilization trends and outcomes, such as patient-centered medical homes, rather than just cost.