De Brantes also referred to expenses for treatment of various diseases or illnesses detailed in Dartmouth Atlas reports. He noted that Dartmouth Atlas found more than a two-fold difference in Medicare spending on patient care from one region of the country to another, during 20 years of studies.
The significant variations in costs of "medical episodes of care has led to well-documented waste in resources and harm to patients and oddly enough, most variability occurs with medical episodes that require the most pressing attention," de Brantes reports. To reduce variations of treatment, De Brantes says health care systems should create a "list of targets" that focus on issues such as "episode costs, price per unit, quantity and mix of services" and potential interventions.
Oddly enough, de Brantes says, while physicians are impacted by financial incentives within organizations, they are often isolated in the process.
"That's often the case for clinicians employed by large medical groups or health systems," de Brantes reports. "External payment incentives are filtered by the organization which decides how to convert those incentives into salaries and other payments for clinicians. This filtering action might have a very different impact on a clinician's motivation than the original, unfiltered incentive."