"In certain cases the increased spending is beneficial," says Mary Beth Landrum, a professor of health care policy at the Harvard Medical School and lead author on the study that will be published in the January/February issue of Health Affairs. "The focus should not simply be on cost containment, but rather on targeting care to the patients who we know will benefit."
Landrum and colleagues looked at a cohort of 55,549 patients who lived in high-spending Medicare areas like Los Angeles and Detroit, low-spending areas such as Iowa, Seattle, and Utah, and more moderate spending areas like San Francisco and Connecticut.
The study found that when factored together, many of the benefits gained in high-spending areas are offset by an over-use of therapies with dubious beneficial results.
"We can make Medicare far more cost-effective not by capping it, but by designing policies that reign in discretionary and non-recommended therapies," said co-researcher Nancy Keating.
