Medical Consultants and the Value of Hospital Care
Investigators: Lena Chen, Mousumi Banerjee, Edward Norton
Funding: Blue Cross Blue Shield of Michigan Foundation, 2014-2017 (Grant number 2059.II)
Reimbursement reforms associated with the Affordable Care Act (ACA) have put pressure on health systems to enhance the efficiency of hospital-based care. Medical consultants are a ubiquitous part of inpatient care. However, hospitals vary as much as six-fold in the proportion of surgical patients who receive at least one visit by a medical consultant.
Variation in use of medical consultants underscores considerable uncertainty surrounding the ideal level and circumstances for their use. In this context, we propose to use national Medicare data to explore the impact of medical consultants on quality (i.e., complications, failure-to-rescue from complications, and mortality) and costs for inpatient surgery (e.g. payments for the index admission, and any readmissions and post-discharge skilled nursing facility stays).