Implications of Regional Differences in Spending
Authors: Howard A. Levin
Journal: Annals of Internal Medicine (2004)

Letters20 January 2004Implications of Regional Differences in SpendingHoward A. Levin, MDHoward A. Levin, MDFrom Health and Disease Strategies, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-2-200401200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The prospect of a 30% decrease in Medicare costs with no degradation in health outcomes is already a powerful incentive for hard-strapped government officials to act. However, as startling as the estimates of saving to the system are, it is possible that this is an underestimate. In the articles by Fisher and colleagues (1, 2), the lowest quintile is assumed to be the benchmark, but this may not be the case. The End-of-Life Expenditure Index includes a highly heterogeneous case mix with many diagnoses and treatment courses. A hospital referral region with overall lower costs might not ...References1. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003;138:273-87. [PMID: 12585825] LinkGoogle Scholar2. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care. Ann Intern Med. 2003;138:288-98. [PMID: 12585826] LinkGoogle Scholar3. Wilensky GR. The implications of regional variations in Medicare-what does it mean for Medicare? [Editorial]. Ann Intern Med. 2003;138:350-1. [PMID: 12585836] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Howard A. Levin, MDAffiliations: From Health and Disease Strategies, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care Elliott S. Fisher , David E. Wennberg , Thrse A. Stukel , Daniel J. Gottlieb , F. L. Lucas , and Étoile L. Pinder The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care Elliott S. Fisher , David E. Wennberg , Thrse A. Stukel , Daniel J. Gottlieb , F. L. Lucas , and Étoile L. Pinder The Implications of Regional Variations in Medicare—What Does It Mean for Medicare? Gail R. Wilensky Implications of Regional Differences in Spending Rudy Fernandes Implications of Regional Differences in Spending George L. Weber Implications of Regional Differences in Spending Hyman Gaylis Implications of Regional Differences in Spending Franklin Gaylis Implications of Regional Differences in Spending Elliott S. Fisher , Dan Gottlieb , and David Wennberg Implications of Regional Differences in Spending Rudolph J. Mueller Implications of Regional Differences in Spending Barry Kisloff Metrics 20 January 2004Volume 140, Issue 2Page: 146KeywordsDiagnosis related groupsEvidence based medicineHospital medicineMedicareMotivationTreatment guidelines ePublished: 20 January 2004 Issue Published: 20 January 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...