Measurement of the quality of care provided by managed care organizations (MCOs) has achieved national prominence, though there is controversy regarding its value. This article assesses the economic implications of a new Health Plan Employer Data and Information Set (HEDIS®) measure for pneumococcal vaccination.
Methods
A Markov decision model, with Monte Carlo simulations, was utilized to conduct a cost-benefit analysis of annual HEDIS-associated interventions, which were repeated for 5 consecutive years, in an average Medicare MCO, using a societal perspective and a 3% annual discount rate.
Results
Compared with the status quo, the HEDIS intervention will be cost saving 99.8% of the time, with an average net savings of $3.80 per enrollee (95% probability interval: $0.73–$6.87).
Conclusions
The new HEDIS measure will save societal dollars. This type of analysis is essential if performance measurement is to become a legitimate part of our health care landscape.
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