Unbiased Analysis of Today's Healthcare Issues

Avoiding unnecessary care: Does insurance coverage matter?

Consumer Reports‘ “Choosing Wisely” initiative aims to identify high-cost, low-value treatments that can often be avoided.  One question remains is why do providers still offer these services?  Do payer coverage policies or reimbursement rules affect these choices? A paper by Colla et al. (2017) attempts to answer that question.  The authors used commercial payer claims data […]

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ASSA 2016: Regional variation in hospital spending among U.S. privately insured patients

How do health care costs vary across the country. Although the team at the Dartmouth Atlas has done this exercise with patients in Medicare, there has been less study of region variation in health care spending among the privately insured with the notable exception of a 2013 Institute of Medicine report. In a study by […]

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What is they key driver of cancer care spending?

High-cost cancer drugs often get bad press. Cancer treatment certainly is expensive. However, drug costs are not the primary driver of high cost of cancer treatment; hospitalizations are. Using data from SEER-Medicare, Brooks et al. (2014) examine regional variation in the cost of cancer care and find: Acute hospital care was the largest component of […]

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Dartmouth, France?

The Dartmouth Atlas is well known for examining regional variation in practice patterns in the U.S. It looks like researchers in France are taking a similar approach to evaluate their own single payer system. A paper by Mercier, Georgescu and Bousquet (2015) find: We assessed disparities in potentially avoidable hospitalizations in France in 2012 and […]

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Regional Growth in Medicare Spending, 1992–2010

Below is an abstract from a paper I co-wrote with Camille Chicklis, Thomas MaCurdy, Jay Bhattacharya, and Dan Rodgers.  The title of the paper is Regional Growth in Medicare Spending, 1992–2010. Objective: To determine if regions with high Medicare expenditures in a given setting remain high cost over time. Data Sources/Study Setting: One hundred percent of national Medicare Parts […]

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Regional Variation in Medical Spending: A Texas Case Study

A large body of research (including my own) indicates that there exists significant regional variation in medical spending. What is the source of these differences: differences in the prices paid per service or differenes in the amount of healthcare services used? The conventional wisdom is that Medicare does a better job of controlling prices, and […]

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Productivity Spillovers: The Case of AMI

The Healthcare Economist has written a lot about the fact that there exists significant regional variation in health care spending.  Is this due to a provider cultural norms?  Or are other factors at play? A paper by Chandra and Staiger (2007) claim that productivity spillovers may explain this results.  I summarize their proposition in more […]

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Dartmouth Response to “Target Decision-makers, Not Geography” Report

The title of the Institute of Medicine’s recent report “Target Decision-makers, Not Geography” at first glance appears to be an indictment of the work of the Dartmouth Atlas, which largely claims that policymakers can reduce healthcare spending by targeting the highest spending geographic areas. A more detailed review shows that the empirical findings from IOM […]

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Regional Variation: Interpretation

The quality and efficiency of the care patients receive is often determined by the accident of where they live and seek care. – Dartmouth Atlas Brief Within-[region] variation in spending and utilization is significantly larger than the across [region] variation for both Medicare and Medicaid.” – Report for the Institute of Medicine. Which statement is […]

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IOM Final Report: Geographic Variation in Health Care Spending

The Institute of Medicine (IOM) was charged with answering two questions: How do health care spending, utilization, and quality vary across geographic regions? Should Medicare provider payments be adjusted for regionally-based measures of value? Based on research conducted by Precision Health Economics, Acumen, and other research firms, IOM reached the following conclusions: Geographic variation in […]

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