Featured Research

from universities, journals, and other organizations

Higher Medicare Spending Yields Mixed Bag For Patients

Date:
January 8, 2008
Source:
Harvard Medical School
Summary:
A large-scale study of over 55,000 colorectal cancer patients found that Medicare beneficiaries in "high spending" areas get better care in some circumstances, but worse care in others. Overall, they do no better than their peers in lower spending areas.

Many recent studies have found that Medicare spending across the country varies greatly. But despite these spending differences, aggregate health outcomes tend to be the same no matter which region a person lives in. Because of this, some policy makers have determined that there is no value to the excess costs in high-spending areas.

Related Articles


A new study that focuses on colorectal cancer as a model suggests this is not correct. While it finds that patients in low spending areas ultimately fare just as well those in high spending areas, the authors find that all care is not alike. A large-scale study of over 55,000 colorectal cancer patients found that Medicare beneficiaries in "high spending" areas get better care in some circumstances, but worse care in others. On net, they do no better than their peers in lower spending areas.

"In certain cases the increased spending *is* beneficial," says Harvard Medical School professor of health care policy Mary Beth Landrum, lead author on the new study. "The focus should not simply be on cost containment, but rather on targeting care to the patients who we know will benefit."

For this study, Landrum and colleagues Nancy Keating and Ellen Meara, also Harvard Medical School faculty, looked at a cohort of 55,549 patients, who were all diagnosed with colorectal cancer between 1992 and 1996, and who were all over age sixty-five and enrolled in Medicare. These patients lived in various locations throughout the US, 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 authors analyzed various aspects of their cancer care, including mortality rates three years post diagnosis.

Although increased spending did not yield improved patient outcomes overall, the authors found that not all increased spending was necessarily wasteful.

"For example, chemotherapy for patients in stage 3 colorectal cancer is very helpful, and people in these high-spending areas receive it and greatly benefit from it," says Landrum. "But in these high-spending areas doctors also tend to give chemotherapy in other cases where it might do more harm than good, such as with older and sicker patients. So it's an example of spending money in cases where there's little or no benefit."

In other words, these results suggest 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.

According to co-author Keating, "We can make Medicare far more cost-effective not by capping it, but by designing policies that reign in discretionary and nonrecommended therapies, while at the same time supporting all recommended care."

Prior studies analyzing Medicare costs and patient outcomes have led some to believe that excess Medicare spending in some areas is wasteful. These findings, however, present a more nuanced picture. Not all care is good, and not all care is bad. As a result, blunt instruments for controlling Medicare costs, as some have suggested, are not likely to be successful.

Journal citation: Health Affairs, January/February, 2008, Volume 27, Number 1. "Is Spending More Always Wasteful? The Appropriateness of Care and Outcomes among Colorectal Cancer Patients." Mary Beth Landrum, Ellen R. Meara, Amitabh Chandra, Edward Guadagnoll, Nancy Keathing 

This research was funded by the National Cancer Institute, the National Institute on Aging, and the Doris Duke Charitable Foundation.


Story Source:

The above story is based on materials provided by Harvard Medical School. Note: Materials may be edited for content and length.


Cite This Page:

Harvard Medical School. "Higher Medicare Spending Yields Mixed Bag For Patients." ScienceDaily. ScienceDaily, 8 January 2008. <www.sciencedaily.com/releases/2008/01/080108082938.htm>.
Harvard Medical School. (2008, January 8). Higher Medicare Spending Yields Mixed Bag For Patients. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2008/01/080108082938.htm
Harvard Medical School. "Higher Medicare Spending Yields Mixed Bag For Patients." ScienceDaily. www.sciencedaily.com/releases/2008/01/080108082938.htm (accessed March 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, March 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) — Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com
Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins