As I frequently report, there is substantial geographic variation in health care spending and utilization across the country. The reasons for this are not completely clear. A new study looks at primary care spending variation. Primary care clinicians in many ways are gatekeepers of the medical system and it is believed that more primary care can help keep patients in better health and lower overall spending. So high primary care spending isn’t necessarily a bad metric.
The study covered 26 million people under age 65 covered by commercial health insurance in 2022. Average primary care spending was a mere $282 per year, varying from from $113 in a suburban New Jersey area to $530 in the Mankato, Minnesota area. When spending was adjusted for demographics, the variation appeared similar. But when price differences were added in, there was some shift in the amount of variation. So price was identified as the main factor in primary care spending geographic variation, with some contribution in utilization differences. A useful follow-on study would focus on whether higher primary care spending leads to higher or lower specialty spending or better health outcomes. (JAMA Study)
