RWJF Content Alert - Geographic Variations in Health Care

Publication Date: 
May 12, 2010

Geographic Variations in Health Care

Articles in New England Journal of Medicine Look at Regional Differences in Health Care Spending

Two articles published today in the New England Journal of Medicine take in-depth looks at how medical practices and spending differ in different geographic areas.

In “Clarifying Sources of Geographic Differences in Medicare Spending,” authors Stephen Zuckerman, Timothy Waidmann and Robert Berenson from the Urban Institute, along with George Mason University’s Jack Hadley, address what they see as a lack of information on reasons for regional differences in Medicare spending. Their analysis provides new insights into how differences in Medicare beneficiaries’ health and personal characteristics can contribute to variation in spending. They call for better methods of risk-adjusting assessments of regional spending to better account for underlying differences in population health. The paper was funded through the Robert Wood Johnson Foundation’s (RWJF) Changes in Health Care Financing and Organization (HCFO) project.

In “Regional Variations in Diagnostic Practices,” authors Elliot Fisher and Jack Wennberg of the Dartmouth Atlas discuss differences in regional health care practices that they say are not likely related to population characteristics. They conclude that the use of clinical or claims-based diagnoses in risk-adjustment may actually introduce biases in comparative effectiveness, public reporting and payment reforms. The Dartmouth Atlas project is a longtime RWJF grantee.