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

Health Affairs

Volumn 31, Issue 5, 2012, Pages 956-964

  Reschovsky, James D ^a   Ghosh, Arkadipta ^b   Stewart, Kate A ^b   Chollet, Deborah J ^b  

^a CENTER FOR STUDYING HEALTH SYSTEM CHANGE   (United States)

^b MATHEMATICA POLICY RESEARCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMBULATORY CARE; ARTICLE; CONSUMER; GEOGRAPHIC DISTRIBUTION; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE UTILIZATION; HOME CARE; HOSPICE; HOSPITAL CARE; HUMAN; MEDICAL INSTRUMENTATION; MEDICAL SERVICE; MEDICARE; OUTPATIENT CARE;

DURABLE MEDICAL EQUIPMENT; HOME CARE SERVICES; HUMANS; INSURANCE CLAIM REVIEW; MEDICARE; UNITED STATES;

EID: 84862504152     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0243     Document Type: Article

References (22)

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8. Beneficiary observations are weighted to account for the survey weight of the Community Tracking Study Physician Survey respondent through whom they were included in the sample and to the number of unique physicians seen during the three-year period. Mean per beneficiary Medicare payments in 2006 were $7,691 in the linked physician survey/claims sample, as compared to $7,995 for all aged Medicare patients in the fee-for-service program. The Centers for Medicare and Medicaid Services mean includes graduate medical education (GME) payments, while the mean from our sample does not. Calculated from Centers for Medicare and Medicaid Services. FFS data (1998-2007) [Internet]. Baltimore (MD): CMS; [last modified 2012 Mar 1; cited 2011 Dec 21]. Available for download from: http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/FFS_Data05a.html
9. To access the Appendix, click on the Appendix link in the box to the right of the article online
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12. The fourteen sites were selected from three Community Tracking Study strata: larger metropolitan sites (twelve), small metropolitan sites (one), and nonmetropolitan sites (one)
13. Most of these ratios are reduced modestly if we exclude Miami from the top quintile, although one, durable medical equipment, declines substantially from 3.54 to 2.13. We also calculated coefficients of variation across the sixty sites, which are highly correlated with the ratios we report.
14. Before adjustment for health, the interquintile difference equaled $8,182.
15. The percentage contribution of each service category among sites in just the top and bottom total cost quintiles very closely mirrors that of the distribution of national costs.
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