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…

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…

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…

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…

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…

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…