In this year's May issue of Health Affairs, four detailed studies look at different Medicare spending trends and what is driving the variations.
• One study examined the relationships between physician fees under Medicare and the Relative Value Scale Update Committee, which is the physician board better known as RUC that recommends physician fee values. The authors found CMS agreed with the RUC on 87.4 percent of their recommendations between 1994 and 2010, but CMS did not necessarily favor specialist physician income values over primary care physician income values.
• In a study of CMS' State Health Expenditure Accounts between 2001 and 2004, researchers found there was almost no relationship between the level of spending for Medicare and Medicaid at the state levels. However, the study's authors did find a strong correlation between the two government payors within hospital referral regions, meaning Medicare and Medicaid spending within those regions could be influenced by local supply of beds, the number of specialists on hand and other tertiary care factors.
• An examination of state-level data on dual eligible patients younger than 65 found that per-person spending varied by up to three times. Per-person spending for dual eligibles, who receive both Medicare and Medicaid benefits, ranged from $16,309 in Georgia to $43,587 in New York.
• In a study of 60 communities across the United States, researchers found variable Medicare spending across different categories of medical services. Home health services and durable medical equipment exhibited the largest variations, which the authors suggested could be linked to high incidences of fraud and abuse.
• One study examined the relationships between physician fees under Medicare and the Relative Value Scale Update Committee, which is the physician board better known as RUC that recommends physician fee values. The authors found CMS agreed with the RUC on 87.4 percent of their recommendations between 1994 and 2010, but CMS did not necessarily favor specialist physician income values over primary care physician income values.
• In a study of CMS' State Health Expenditure Accounts between 2001 and 2004, researchers found there was almost no relationship between the level of spending for Medicare and Medicaid at the state levels. However, the study's authors did find a strong correlation between the two government payors within hospital referral regions, meaning Medicare and Medicaid spending within those regions could be influenced by local supply of beds, the number of specialists on hand and other tertiary care factors.
• An examination of state-level data on dual eligible patients younger than 65 found that per-person spending varied by up to three times. Per-person spending for dual eligibles, who receive both Medicare and Medicaid benefits, ranged from $16,309 in Georgia to $43,587 in New York.
• In a study of 60 communities across the United States, researchers found variable Medicare spending across different categories of medical services. Home health services and durable medical equipment exhibited the largest variations, which the authors suggested could be linked to high incidences of fraud and abuse.
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http://healthaffairs.org/blog/2012/05/07/medicare-spending-issues-are-a-focus-of-new-health-affairs-issue/