California medical groups ranked on cost of care

California's Office of the Patient Advocate (OPA) has issued its annual report card on the state's medical groups, but added a new feature rarely seen in such evaluations: The annual cost of each provider's care.

In an interview with FierceHealthFinance, OPA Executive Director Elizabeth Abbott said that that the cost of delivering care to a single patient during the course of the year averaged $3,158. The medical groups were rated among four different tiers for cost: Less than the $3,158 average; less than $3,915 per year; less than $4,744 per year and more than $4,744 per year.

The costs include most services, including hospitalizations and drugs, but excludes mental health and other services that are often delivered outside of a traditional provider network, according to Abbott.

"We felt we should include costs to provide the entire picture," she said. Abbott added that California is the only state other than Minnesota that ranks and rates providers based on the cost of care delivered.

"The public reporting of total cost of care, alongside clinical quality and patient experience, at the physician organization level in California marks a milestone for healthcare transparency and shifting the focus from volume to value in healthcare," said Jeffrey Rideout, M.D., chief executive of the Integrated Healthcare Association (IHA), in a statement. The IHA, which engages in a variety of quality and pay-for-performance initiatives, gathered the cost data for the OPA.

Medical groups have been fairly aggressive in controlling costs in recent years, with many supporting shifting care to lower-cost settings. 

Just 11 medical groups out of more than 200 were rated below the $3,158 average. The largest number, 108, were ranked in the tier just below $4,744 per year and more than $3,916 per year. A total of 28 groups were ranked as providing care that cost more than $4,744.

Abbott said that there may be an expansion of cost data to other OPA report cards, which also includes quality data on insurers.

To learn more:
- read the OPA report 
- check out the IHA statement

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