Axel Drainville/Flickr A view from the Bronx in the direction of Manhattan.When it comes to Medicare, Bronx, Contra Costa, eye have Calif., and McAllen, Texas, the gimlet get because doctors and hospitals it more Medicare per receiver than any other money.
One which was the primary suspect, that too many tests and procedures to make extra money performing providers of health care in these areas.
But a new Government analysis clouds the clear line between the regions of high - and low expenditure. If the severe patient's disease and special local issues are taken into account, flip some of these areas by ruthlessly average or even economical, according to the calculations of the federal Centers for Medicare & Medicaid Services.
?For example 55 percent higher than the national average in raw dollars for the Bronx, but only 15 per cent higher than the national average after without additional payments, the Medicare provides for higher wages and special programs. And much of the extra expenditure of an above average number of patients with chronic kidney disease diseases, diabetes and heart problems were responsible. If all of this into account was considered average per patient fell the Bronx expenditure by $6.719, or 10 percent lower than the national average.
In Mesa, Arizona, 5 percent below the average was spending. But the average Mesa Medicare patient was some younger and suffer less serious disease than the national average. After all adjustments, the average Medicare spending in Mesa was $8,370, the it 12 percent above the average.
The new data type ammunition defender of some areas high costs as it confirmed the existence of significant variations in Medicare spending across the country - something the researchers at the Dartmouth Atlas of health care have documented for decades. Total in the CMS analysis, 87 of the country 306 hospital markets turned out higher than average to less than average spend money or the other way around for patient health and geographical cost factors were considered.
The CMS analysis may new feed for an ongoing debate in the Congress and health provide political circles of Medicare payments to reward places, to change the good medical care at a reasonable price. The data have been requested by the Institute of medicine, examines the geographic variation in health care spending.
"If you look at the data, you'll see that high cost areas have sicker patients", says James Reschovsky, a senior researcher at the Center for studying health system change, a Washington think tank.
Adapted to CMS for these factors, but it remained a significant spread in expenditure between regions. In 2008, Medicare spent $9,468 for the average recipient in Monroe, La., but only $4,959 in Honolulu. McAllen, Texas remained a super donor at $9,370.
In CMS calculations was the national average expenditure per Medicare recipient $7,500 after the special payments were removed and the type of patients disease into account.
Expenditure on health care, studied health policy Professor, Harvard's Michael Chernew, geographical variation, warns danger is, if really high expenditure of arguments discussing the regions dominated.
"Health care, we could improve our system, if we knew the best and worst ways to" medicine, says Chernew. "The real contribution" of research, he says, "is to demonstrate that there is not a unique practice patterns, the country is respected."
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