It has been a long-standing observation that there is significant geographic variation in Medicare spending per beneficiary, even after regional price adjustments. A lot of research has been done on this topic. Some of it finds that there isn’t that much variation when health status is taken into account and other studies find that even after those adjustments there is a lot of variation. Most of it is attributed to different physician practice patterns and even in the same geographic location doctors are found to practice differently. The same variation occurs for people covered by commercial insurance. This study looked at how much of the variation might be due to social determinants of health, another hot area of research. (JAMA Study) Social determinants includes things like race, income, education, etc. After appropriately adjusting for health status and other factors, these social determinants accounted for only about 6% of the variation in spending, compared to 38% before adjustment. 62% of the variation was actually explained by clinical factors relating to the patient’s condition. The study is a good example of why adjustment for factors that might contribute to an apparent causal relationship is important. It also reflects the limited role that social determinants play, and the more important role of patient health and condition.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Two health care firms owned by private equity firms are merging in a transaction supposedly valued at $3 billion. HealthComp administers self-funded plans for employers and other groups and Virgin...
September 27, 2023
NextGen, an electronic medical records firm, is being put out of its public company misery, as a PE firm will pay $1.6 billion for the one-time high-flier.
September 7, 2023
A number of companies which attracted large financing rounds during the epidemic have imploded when reality set in. The latest is Cano Health, which is a little surprising since it...
August 15, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace