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Cost-Benefit Analysis of a New HEDIS Performance Measure for Pneumococcal Vaccination

Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA fahmed{at}cdc.gov

Elamin E. Elbasha, PhD

Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA

Betsy L. Thompson, MD, MSPH

Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA

Jeffrey R. Harris, MD, MPH

Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA

Vishnu-Priya Sneller, MBBS, PhD

National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA

Objectives. Measurement ofthe 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 ofa 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% ofthe 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.

Key Words: cost-benefit • cost-effectiveness • health maintenance organizations • intervention • managed care programs • outcomes assessment (health care) • performance measures • pneumococcal vaccine • quality of health care

Medical Decision Making, Vol. 22, No. 5 suppl, S58-S66 (2002)
DOI: 10.1177/027298902237711


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