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What Are the Policy Implications of a Volume-Outcome Relationship?
Pages 10-16

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From page 10...
... Mentonng approaches nave been effective in the adoption of new technology, where providers mentored by experienced practitioners helped novices move up the "learning curve." Simulation models would also be helpful, although relatively few examples of this approach are available. In concluding the morning session, Dr.
From page 11...
... . The Leapfrog Group has developed a set of health plan performance standards that include volume standards for specific conditions, but it will recommend better measures when they become available Information about volume can be applied without public disclosure, for example, within systems of care for quality improvement programs.
From page 12...
... Consumer perspectives Ellen Stovall, National Coalition of Cancer Survivorship and National Cancer Policy Board; and Art Levin, Center for Medical Consumers . Purchaser perspectives Bruce Bradley, General Motors; and Stephen CIauser, Health Care Financing Administration .
From page 13...
... HCFA is funding research to better understand the underpinnings of the volume-outcome relationship. A 13-state prospective outcome assessment study examining carotid endarterectomy and a number of PRO quality improvement initiatives in surgery safety and outcomes may guide Medicare decisions.
From page 14...
... There could be a significant provider and/or consumer backlash if selective referral is widely implemented, unless all industry stakeholders demonstrate agreement. Provider Group Perspective Dr.
From page 15...
... In contrast, less than one-half of patients in California undergo surgery in such high-volume settings. The New York regulatory process exists alongside a voluntary program, the cardiac surgery reporting system.
From page 16...
... Findings can then be used to enhance the performance of providers. in an examination of the surgeon volume-outcome relationship among patients undergoing carotid endarterectomy in New York State, volume effects disappeared when type of surgeon was controlled for in the analysis (i.e., vascular surgeons had lower risk-adjusted mortality rates than either general surgeons or neurosurgeons)


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