Variation in medical care: time for action.

Variations research has broken new ground by moving analysis of Medicare data from the community to the hospital level. The California study of hospitals further illustrates the power of comparing performance to demonstrate the levels of efficiency that can be achieved. WellPoint, replicating the Dartmouth approach with its commercial data, is partnering with medical specialty societies to make data "actionable" and move beyond benchmarking to help providers alter practice patterns. The shared goal is to achieve a material reduction in practice variation throughout health care. Key elements of their partnership include establishing national databases, reducing the administrative burden for pay-for-performance programs and using evidence-based metrics.