Tracking Private and Medicare Costs by Clinical Condition

This grant will provide additional programming and analytic support to a previously approved project investigating the drivers of cost growth in private insurance and Medicare enrolled populations. More specifically, through funding for data licensing software and additional analytic work, this small grant will support the analyses of health care spending and utilization trends by clinical episode groups. Health care spending analyses tend to be organized based on the site of care received (such as a hospital or nursing home), however, this conceptualization contributes to the fragmented nature of payment for care and impedes transitions towards patient-centered care. The episodic approach that this project will support is more consistent with how care is actually delivered and better aligns with the direction of payment and delivery reform, which aims to encourage greater coordination of care across the health care system. This work will provide a new analytic perspective that is more clinically relevant and actionable for health care system leaders and policymakers.