title: Can data envelopment analysis provide a scalar index of 'value'?
abstract: The concept of 'value' typically includes a combination of cost and quality measures. Some approaches to incorporating value into payment systems treat cost and quality as separate dimensions, but policymakers have expressed interest in a single scalar index that combines cost and quality. Treating risk-adjusted cost as an input and multiple measures of quality as outputs, we examine whether data envelopment analysis input efficiency is associated with higher quality and lower cost in a sample of physician practices using 2008 US Medicare claims data from Colorado. The findings suggest that input efficiency might provide a useful scalar measure of value for a value-based payment system for physician services.
authors.affiliation: HSRP, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Dowd
authors.forename: Tami
authors.initials: T
authors.lastname: Swenson
authors.forename: Robert
authors.initials: R
authors.lastname: Kane
authors.forename: Shriram
authors.initials: S
authors.lastname: Parashuram
authors.forename: Robert
authors.initials: R
authors.lastname: Coulam
mesh_terms: D003120:Colorado; D003365:Costs and Cost Analysis; D058006:General Practice / Q000191:economics; D006801:Humans; D007345:Insurance Claim Review; D006278:Medicare; D015233:Models, Statistical; D011445:Prospective Payment System; D011787:Quality of Health Care / Q000191:economics*; D013223:Statistics as Topic / Q000379:methods; D014481:United States; D062505:Value-Based Purchasing
keywords: cost; data envelopment analysis; payment; quality; value