Health Care Spending Varies Locally – a Lot

Study results:

There was substantial local variation in health care (drug and nondrug) utilization and spending. Furthermore, many of the low-spending HSAs [hospital service areas] were located in high-spending HRRs [hospital referral regions], and many of the high-spending HSAs were in low-spending HRRs. For drug spending, only 50.7% of the HSAs located within the borders of the highest-spending quintile of HRRs were in the highest-spending quintile of HSAs; conversely, only 51.5% of the highest-spending HSAs were located within the borders of the highest-spending HRRs. Similar patterns were observed for nondrug spending.

Comments (9)

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  1. Cindy says:

    I’m confused — what’s the correlation? I think I may need to read this whole study, but it’s interesting the amount of variation. It seems to indicate one-size-fits-all solutions fail.

  2. Alex says:

    I’m with Cindy, I don’t quite understand what this all means.

  3. Studebaker says:

    It doesn’t surprise me that there is variation in Medicare spending. What surprises me is that once one region figures out how to bill for more services, other regions don’t follow suit! That doesn’t make sense. In 1849 when news of gold in California spread to the East Coast and the Midwest, people headed to California in droves – in covered wagons no less. You’d think that when news of Medicare Gold spreads from one hospital region to another, every doctor in America would copy the high spending regions.

  4. Paul says:

    I don’t get it…

  5. Peterson says:

    The study offers very interesting analysis…

  6. Jason says:

    I’ve always been very intrigued by the reasons to why this happens. I understand variations in spending at an international level, or even nationwide, but locally? I would think that if policies and regulations are equally enforced throughout local areas, then there should be no major difference as to how much is spent. This goes to show the lack of consistency, in both costs and spending, there is in this system.

  7. Robert says:

    Agreed on the confusion– what is the significance of the HRR vs HSA?

  8. seyyed says:

    interesting, maybe some clarification of what an HSA and HRR are along with some examples will help clear things up

  9. August says:

    Basically: get more specific data, draw better conclusions.

    “Evidence regarding variation has focused on hospital referral regions (HRRs), which incorporate numerous local hospital service areas (HSAs). If there is substantial variation across local areas within HRRs, then policies focusing on HRRs may be poorly targeted.”