EXHIBIT 1. Illustrative examples of publicly reported cost measures (cost measure bolded).
| Type of Provider? |
Where? | What cost measure captures | |
|---|---|---|---|
| Aetna’s Aexcel Network (36) |
Physicians | National | In their provider directory, Aetna places stars next to physicians who on average are lower cost than their peers based on a cost profile. Cost profiles are generated based on the costs of treating an episode of care (i.e., treating a particular disease or acute event). The focus of this program is on physicians in 12 specialties. To meet designation status, the physicians must also meet a quality threshold. |
| Hospital Compare(37) |
Hospital | National | On this website run by the Center for Medicare and Medicaid Services, a person selects a specific condition (e.g., pneumonia) and a geographic region. The website then displays the volume of cases and Median Medicare reimbursement for related categories of hospitalizations such (e.g. “Simple pneumonia and pleurisy (DRG 193)”) for hospitals in that region. |
| Quality Quest (38) | Physician clinic |
Illinois | This website targets consumers. A consumer selects one of 7 different kinds of providers (e.g. behavioral health, primary care) and one of 19 counties. For each provider in the county, the website displays the percent of prescriptions that are generic and how that compares to a “high performer.” |
| NJ Hospital Price Compare (39) |
Hospital | New Jersey |
The goal of this website is to provide consumers an ability to compare charges at New Jersey’s acute care hospitals. A consumer selects a hospital and diagnosis (e.g., “DRG 552 (Medical back problems w/o MCC”). The website displays the average length of stay and charges for the hospital compared to several sets of comparison hospitals such as “hospitals with similar licensed beds” |
| Nursing Home Guide. (40) |
Nursing Homes |
Florida | Website users select a region and then a specific nursing home. Each nursing home has a webpage which provides a range of information including quality scores and lowest daily charge for the nursing home. |
SOURCE: Author’s analysis