Strategies for improving the quality, efficiency, and overall spending for Medicare services generally focus on three categories of care namely, effective-care, preference-sensitive care, and supply-sensitive care. The effective-care therapy category is usually defined as a medically necessary care on the basis of clinical outcome evidence. Effective-care therapy usually elicits only a small proportion of spending for Medicare services. Preference-sensitive care of Medicare services are related to treatment options involving significant tradeoffs that must be based on the patient's own values. This type of care tends to be misused because of the failure to communicate the risks and benefits of alternative treatments. Supply-sensitive care identifies a type of health care where the supply of resources governs the frequency of their use. Supply-sensitive care tends to be overused in the management of chronic illness. The causes of such include the lack of infrastructure to support continuous management of chronically ill patients and overdependence on acute hospital care. Hospital-specific measures could be used to profile performance in chronic illness management and could help identify more efficient providers. In relation to these hospital-specific measures, a research called the Dartmouth Atlas Project was conducted to eamine Medicare services in 77 hospitals and academic medical centers. The researchers of the project found that the hospitals differed in the way they managed severely ill Medicare patients. The said project essentially helped gauge the relative efficiency of specific health care organizations in managing chronic illness in Medicare patients. The results of this study are epected to stimulate payers to reevaluate their health provider networks towards improving the overall quality and efficiency of Medicare services. -- June 19, 2009 @ 3:57 pm