Durable medical equipment and home health among the largest contributors to area variations in use of Medicare services

Health Affairs
J ReschovskyDeborah J Chollet

Abstract

Most analyses of geographic variation in Medicare spending have focused on total spending. However, focusing on the volume and intensity of specific categories of services delivered to patients could help identify ways to lower costs without having a negative impact on care. We investigated how utilization in thirteen medical service categories in Medicare Parts A and B (for hospital and physician insurance, respectively) varied across sixty communities nationwide. We found considerable geographic variation in the use of some service categories, although not all. We also found that local communities used very different combinations of types of services to produce medical care, that some service categories were substituted for others, and that the mix of service categories differed even among sites with high or low total medical utilization levels. Home health and durable medical equipment were major drivers of total geographic service use variation because of their variation across sites. They may therefore be appropriate targets for policy interventions directed at increasing efficiency.

References

Sep 29, 2004·Health Affairs·Katherine Baicker, Amitabh Chandra
May 4, 2006·Annals of Internal Medicine·Brenda E SirovichElliott S Fisher
Jan 30, 2010·Health Affairs·Daniel J GottliebJason M Sutherland
May 14, 2010·The New England Journal of Medicine·Stephen ZuckermanJack Hadley
Feb 11, 2011·Health Services Research·James D ReschovskyEllyn R Boukus

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Citations

Feb 2, 2006·Care Management Journals : Journal of Case Management ; the Journal of Long Term Home Health Care·UNKNOWN Medicare Rights Center
Jul 9, 2013·Health Services Research·James D ReschovskyBruce E Landon
Dec 4, 2020·Journal of the American Geriatrics Society·Jinjiao WangYue Li
Jan 5, 2021·Journal of the American Geriatrics Society·Jinjiao WangYue Li

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