Quantifying Productivity Growth in the Delivery of Important Episodes of Care within the Medicare Program Using Insurance Claims and Administrative Data
We assess changes in multifactor productivity in delivering acute episodes of care (including services received after initial discharge from a hospital) for elderly Medicare beneficiaries over 2002–2014. For a majority of the eight episode types studied, productivity improved, exceeding an annualized growth rate of 1.0 percent in some cases. There is some evidence of negative productivity growth for heart failure episodes over this period. Our estimates reflect—and are meaningfully affected by the measurement of—trends in the quality of care, with patients experiencing improved outcomes for most episode types.
We thank Helen Levy, Matthew Shapiro, Katharine Abraham, Ron Jarmin, Brian Moyer, an anonymous reviewer and participants in the NBER-CRIW conference on Big Data for 21st Century Economic Statistics for helpful comments. Andrea Batch, Tommy Chiou and Peter Shieh provided excellent research assistance. The views expressed in this paper are solely those of the authors and do not necessarily reflect the views of the Bureau of Economic Analysis. John Romley has a consulting relationship with the Bureau.
This research was supported by grants from the National Institutes on Aging (P01AG033559 and RC4AG039036). Goldman is a consultant to Precision Health Economics and holds equity (<1%) in its parent company and reports personal fees or honoraria from the Aspen Institute, ACADIA Pharmaceuticals, Amgen, Avanir Pharmaceuticals, and Celgene outside this study. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
John A. Romley
John Romley has a consulting relationship with the Bureau of Economic Analysis.Neeraj Sood
Neeraj Sood reports personal fees from American Medical Association, Virta Health, Precision Health Economics, H&H Wholesale, Crueger Dickinson, PhRMA, and Payssurance outside the submitted work.