Open AccessGeographic Variation In Medicare Per Capita Spending Narrowed From 2007 To 2017
Author(s) -
Yongkang Zhang,
Jing Li
Publication year - 2020
Publication title -
health affairs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.837
H-Index - 178
eISSN - 2694-233X
pISSN - 0278-2715
DOI - 10.1377/hlthaff.2020.00188
Subject(s) - decile , per capita , geographic variation , health spending , demography , variation (astronomy) , health care , demographic economics , health insurance , medicine , economics , environmental health , statistics , economic growth , population , physics , mathematics , sociology , astrophysics
We examined the trends in geographic variation in Medicare per capita spending and growth from 2007 to 2017 and found that the variation narrowed during this period. The difference in Medicare price- and risk-adjusted per capita spending between hospital referral regions (HRRs) in the top decile and those in the bottom decile decreased from $3,388 in 2007 to $2,916 in 2017-a reduction of $472, or 14 percent. The spending convergence occurred almost entirely between 2009 and 2014, during the early years of the Affordable Care Act (ACA). The highest-spending HRRs in 2007 had the lowest annual growth rates from 2007 to 2017, and the lowest-spending HRRs in 2007 had the highest annual growth rates. We also found that a greater supply of postacute care providers, especially hospice providers, significantly predicted lower spending growth across HRRs after the implementation of the ACA.