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Regional Disparities Seen for Diagnoses, Medicare Spending

Researchers say a better understanding of regional Medicare spending drivers is crucial to cost control

WEDNESDAY, May 12 (HealthDay News) -- There are substantial differences in diagnostic practices across U.S. regions, and policymakers looking to control Medicare costs first must understand the sources of the substantial regional differences in Medicare spending, according to a pair of studies published online May 12 in the New England Journal of Medicine.

Yunjie Song, Ph.D., of Dartmouth Medical School in Hanover, N.H., and colleagues used Medicare data from 1999 to 2006 to group U.S. geographic regions in quintiles by intensity of physician/hospital services, and then tracked diagnoses for beneficiaries moving between regions in different quintiles. The researchers found that, as the beneficiaries aged, there was a higher average number of diagnoses for those who moved to a region in a higher quintile than for those who moved to a region in the same or a lower quintile. Moving to each higher quintile increased Hierarchical Condition Category scores by 5.9 percent.

In another study, Stephen Zuckerman, Ph.D., of the Urban Institute in Washington, D.C., and colleagues used Medicare Current Beneficiary Surveys for 2000 to 2002 to assess differences in Medicare spending per beneficiary by regions grouped in quintiles. They found that adjusted Medicare spending per beneficiary was 33 percent higher in geographic regions in the highest spending quintile compared to those in the lowest quintile (unadjusted spending was 52 percent higher).

"Policymakers attempting to control Medicare costs by reducing differences in Medicare spending across geographic areas need better information about the specific source of the differences, as well as better methods for adjusting spending levels to account for underlying differences in beneficiaries' health measures," Zuckerman and colleagues write.

Abstract - Song
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Abstract - Zuckerman
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