--- title: Cost, Quality and Value in CABG description: Read how researchers matched clinical patient-level data to define value in CABG and provide a framework to identify high-value centers. image: https://blog.transonic.com/hubfs/Value_in_CABG.jpg --- [![Customer Login](https://no-cache.hubspot.com/cta/default/40716/9ebb5f25-e3e3-45fd-b525-1b9073c47d36.png)](https://cta-redirect.hubspot.com/cta/redirect/40716/9ebb5f25-e3e3-45fd-b525-1b9073c47d36) [![Transonic_logo-456](https://blog.transonic.com/hs-fs/hubfs/email-assets/newsletter/Transonic_logo-456.png?width=190&height=50&name=Transonic_logo-456.png "Transonic_logo-456")](https://www.transonic.com/) [![Talk with an Expert](https://no-cache.hubspot.com/cta/default/40716/44c87484-21b7-4747-832d-28806f592c2d.png)](https://cta-redirect.hubspot.com/cta/redirect/40716/44c87484-21b7-4747-832d-28806f592c2d) ![mail-icon](https://blog.transonic.com/hubfs/Transonic_2019/Images/mail-icon.png) ## Hear more from our team: - [** ](https://www.facebook.com/sharer/sharer.php?u=https://blog.transonic.com/cardiothoracic-surgery/cost-quality-value-in-cabg&title=Cost,%20Quality%20and%20Value%20in%20CABG&picture=http://cdn2.hubspot.net/hubfs/40716/Value_in_CABG.jpg&description=Read%20how%20researchers%20matched%20clinical%20patient-level%20data%20to%20define%20value%20in%20CABG%20and%20provide%20a%20framework%20to%20identify%20high-value%20centers.) - [**](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.transonic.com/cardiothoracic-surgery/cost-quality-value-in-cabg&title=Cost,%20Quality%20and%20Value%20in%20CABG&summary=Read%20how%20researchers%20matched%20clinical%20patient-level%20data%20to%20define%20value%20in%20CABG%20and%20provide%20a%20framework%20to%20identify%20high-value%20centers.) - - [**](mailto:?subjetc=&body=Cost%2C+Quality+and+Value+in+CABG%20-%20https://blog.transonic.com/cardiothoracic-surgery/cost-quality-value-in-cabg) # Cost, Quality and Value in CABG By [Susan Eymann, MS](https://blog.transonic.com/cardiothoracic-surgery/author/susan-eymann-ms)17 Feb 2016 ![Value in CABG](https://blog.transonic.com/hs-fs/hubfs/Value_in_CABG-1.jpg?width=348&name=Value_in_CABG-1.jpg "Value in CABG")Pay-for-performance measures, as part of the Affordable Care Act, aim to reduce healthcare costs by linking value to Medicare payments. In order to define value in coronary artery bypass grafting ([CABG](https://blog.transonic.com/improve-cabg-graft-patency)) and provide a framework to identify high-value centers, a group of researchers matched clinical patient-level data from multi-institutional statewide databases of 42,839 patients undergoing CABG with cost data. Hierarchical models with adjustments for relevant preoperative patient characteristics and comorbidities were used to estimate center-specific risk-adjusted costs and risk-adjusted postoperative length of stay. Variation in value across centers was assessed by the correlation between risk-adjusted measures of quality (mortality, morbidity/mortality) and resource use (costs and length of stay). The researchers found that there were no significant correlations between risk-adjusted costs and risk-adjusted mortality or morbidity/mortality across centers. Risk-adjusted costs and length of stay were not significantly associated. The differences in cost accounting across centers may explain this lack of correlation between risk-adjusted quality and risk-adjusted cost measures. When risk-adjusted length of stay and morbidity/mortality were used for the framework, there was a strong positive correlation, indicating that higher risk-adjusted quality is associated with shorter risk-adjusted length of stay. Risk-adjusted length of stay and risk-adjusted combined morbidity/mortality are important outcome measures for assessing value in cardiac surgery. The proposed framework can be used to define value in CABG and identify high-value centers. This provides information for quality improvement and pay-for-performance initiatives associated with adverse events that are more suitable for prioritizing quality improvement efforts. References: Osnabrugge RL, Speir AM, Head SJ, Jones PG, Ailawadi G, Fonner CE, Fonner E Jr, Kappetein AP, Rich JB. “Cost, quality, and value in coronary artery bypass grafting,” J Thorac Cardiovasc Surg. 2014; 148(6): 2729-35. 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