How warranted and unwarranted variation affect medicare


Question: How does warranted and unwarranted variation affect Medicare reimbursements? Give examples and resources

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One strategy to improve the quality of care by reducing unwarranted variation is to establish standardized care processes and clinical guidelines (e.g., health maintenance and preventive guidelines, diagnostic algorithms, indications for intervention), supported by best practices, scientific evidence, and expert opinions (Burton, 2013). For example, establishing a stroke protocol to standardize the process to minimize the time from symptom onset to intervention and enhance the quality of care and improve outcomes. Additionally, the utilization of benchmarking and report cards can reduce unwarranted variations in practice by generating incentives to improve performance and quality (Nash et al., 2019). Another strategy to improve quality and value and decrease unwarranted variations is to integrate care delivery systems to better coordinate and optimize care for patients and eliminate the duplication of care (Porter & Lee, 2013; Sabbatini et al., 2014).

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