Measuring Cost and Efficiency in Health Care
Existing efforts in the Quality Alliances and elsewhere have developed an expanding set of quality-of-care measures, but cost-of-care measures have not been consistently implemented, even though cost information is essential to determining the value of care. This lack of broad acceptance of the proprietary cost-of-care measures currently available is due to the shortage of publicly-available information on their validity and reliability. Full transparency in the development of these measures is a critical requirement for their use.

Developing Episode-Based Cost-of-Care Measures Will Help Improve Quality and Lower Cost
The American Board of Medical Specialties Research and Education Foundation, in collaboration with the Engelberg Center, developed and tested episode-based cost measures for 12 common health care conditions.   
 
Working Measure Specifications
The following documents include written specifications and accompanying technical appendices for 22 separate episode-based cost-of-care measures. The measures will be submitted to the National Quality Forum for review as appropriate calls for resource use measures are issued.  
 

• Acute Myocardial Infarction (AMI) Episode-of-Care for 30 days Following Onset
• Acute Myocardial Infarction (AMI) Episode-of-Care for Post-Acute Period (Days 31-365 Days Post-Event)

• Episode-of-Care for Diabetes Over 1-Year Period 

• Episode-of-Care for Management of Chronic CHF Over 1-Year Period
• Episode-of-Care for Post Hospitalization Management of CHF over 4-Month Period

• Episode-of-Care for Management of Chronic Coronary Artery Disease Over 1-Year Period
• Episode-of-Care for Management of Coronary Artery Disease Post Revascularization Over 1-Year Period

• Episode-of-Care for Acute/Sub-Acute Lumbar Radiculopathy With or Without Lower Back Pain
• Episode-of-Care for Simple Non-Specific Lower Back Pain (Acute and Sub-Acute) 

• Episode-of-Care for Community-Acquired Pneumonia Hospitalization
• Episode-of-Care for Ambulatory Pneumonia Episode

• Episode-of-Care for 60-Day Period Preceding Breast Biopsy
• Breast Cancer Episode-of-Care for Treatment in Newly Diagnosed Cases of Breast Cancer Over a 15-month Period

• Episode-of-Care for 21-Day Period Around Colonoscopy
• Colon Cancer Episode-of-Care for Treatment of Localized Colon Cancer 

• Asthma Episode-of-Care for Patients with Asthma Over a One-Year Period

• Chronic Obstructive Pulmonary Disease (COPD) Episode-of-Care for Stable COPD Over a One-Year Period
• Chronic Obstructive Pulmonary Disease (COPD) Episode-of-Care for Unstable COPD Over a One-Year Period

• Gastroesophageal Reflux Disease (GERD) Episode-of-Care for 12-Month Period of GERD Treatment
• Gastroesophageal Reflux Disease (GERD) Episode-of-Care for 12-Week Period of GERD Treatment 

• Sinusitis Episode-of-Care for Ambulatory Management Episode of Acute/Acute-Recurrent Sinusitis

• Sinusitis Episode-of-Care for Chronic Sinusitis