Groundbreaking study identifies eight key metrics that could bend cost curve in U.S., U.K.

EMERYVILLE, Calif., June 3, 2013 – A new study of how healthcare resources are used in the United Kingdom highlights lessons that are likely to be equally important for the U.S. healthcare system. The study, “The Challenge Facing Clinical Commissioning Groups: Reducing Variation in Use of Resources,” reveals how the U.K.’s Clinical Commissioning Groups could free up $2 billion to be reinvested in more cost-effective models of care. The study, conducted by MedeAnalytics, a leading provider of healthcare performance management solutions, was unveiled today at Health Datapalooza IV, a gathering of U.K. and U.S. policymakers in Washington, D.C.

Groundbreaking Analysis Shines Light on Variations in Resource Use
“Our analysis included a year of data covering all patient-level activity and associated costs that take place in hospitals in England,” said Mike Gallagher, MedeAnalytics’ executive chairman and study co-author. “Our study brings to light variations in the use of resources across the NHS.”

More Precision Regarding Areas for Possible Improvement
According to Ken Perez, MedeAnalytics’ senior vice president of marketing and director of healthcare policy, the research builds on the good work of other organizations, such as the King’s Fund, which have published lists of priorities for the NHS’s 212 Clinical Commissioning Groups (CCGs). Perez served as editor of the study’s white paper. “Many organizations publish lists of priorities for CCGs, but this analysis went further, identifying eight key metrics and quantifying the potential national impact of more consistent performance across England,” said Perez. According to Perez, CCGs are responsible for engaging healthcare providers and paying for their services, making them somewhat similar to payer organizations in accountable care arrangements in the U.S. healthcare system.

Eight Key Metrics Shine Light on Path to Bending the Cost Curve Through Reduced Variation
“If every Clinical Commissioning Group achieved the average level of performance for eight key metrics identified in the study, we estimate that could generate annual savings of some £880 million or 1.4 percent of total current hospital expenditures in England,” shared Perez. “To put this in perspective, gains of this amount would allow England to achieve more than 10 percent of its annual savings target. If the best (upper quartile) levels of performance were achieved everywhere, the savings would exceed £1.6 billion (2.5 percent of total current hospital spend).

The eight key metrics identified in the study are:

  • Emergency admissions with 0-1 day length of stay
  • Inappropriate admissions
  • Readmissions within 30 days
  • Outpatient procedures carried out as inpatient same-day procedures
  • Follow-up outpatients to first outpatients visits ratio
  • Walk-in/inappropriate accident and emergency visits during general practitioner clinic hours
  • Admissions for long-term conditions
  • Fall

MedeAnalytics Part of NHS Delegation Attending Health Datapalooza IV Led by U.K. Health Minister
A MedeAnalytics executive, Anthony (Mac) McKeever, is part of the UK delegation attending Health Datapalooza IV. McKeever, one of the authors of the study, is chief executive of MedeAnalytics’ UK business unit and a former chief executive of both hospitals and commissioning organizations in the NHS. Commenting on how the study’s findings would be used, he said, “Tackling variation takes time. Assembling actionable information is simply the first step. If they don’t have it already, we can provide any CCG with figures relating to their geographic area. But only they understand local needs and priorities well enough to turn the data into plans with sensible timeframes.”

About MedeAnalytics
Founded in 1994, MedeAnalytics delivers performance management solutions across the healthcare system—including hospitals, physician practices and payers—to ensure accountability and improve financial, operational and clinical outcomes. For more information, visit www.medeanalytics.com.