Geographic Variances in Medicaid Spending – And the Winner Is?

July 7th, 2011 by Nick Jacobs Leave a reply »

Health Affairs cover - Nick Jacobs, FACHE - Medicare - MedicaidWhen Health Affairs released a first-ever study of geographic variances in Medicaid spending on July 7th, it was a new twist on transparency that is just the beginning of what will become a detail-by-detail exposé of care and treatment of patients in the United States.  Just imagine a few years from now, when every record is electronic and every detail will be instantly available to the government.  Like this variance report, we will begin to see the good, the bad and the ugly of how medicine is practiced in this country.  So… how do you spell transparency?

A few weeks ago, the New York Times ran an article in which the “overuse of Medicare-funded CT scans” was explored. Featured in the digital version of this article was an interactive map showing virtually every hospital in the United States, and as the mouse was passed over each hospital, the percentage of inappropriate CT scans appeared above the facility’s name. If yours was one of the hospitals that was 80+ percent over using this device in multiple single-day scans, you were, as they say, “busted.”

Well, this release exposed at least one entire section of the country that is overusing Medicaid on numerous levels.  Although the study revealed a wide variance in per-beneficiary spending, one geographic region outshined them all.  The findings showed that after adjusting for the case-mix of patients, variations are driven mostly by volume of services provided and, to a lesser degree, by price.  Per-beneficiary spending in the ten highest states was $1,650 above the national average, mostly caused by the greater number of services provided.

Image credit: New York Times

One of the most significant findings revealed by this study was that the supply of primary care physicians in specific areas was associated with reduced rates of admissions for diabetes, lung disease, and adult asthma.  The authors suggest that this finding might point to the fact that increased access to primary care providers may result in improved management of common chronic diseases for people on Medicaid.

So, by now you’re asking, “Who won?  Who used more money per capita to treat Medicaid patients?”  It was The Mid-Atlantic States : New Jersey, New York and Pennsylvania used more Medicaid funds per capita than any of the regions in the United States. For example, the per beneficiary cost in New York was twice that of California; $21,195 for New York vs. $11,200 for California.

As a region, New England used the least amount of Medicaid resources and as a state, Washington provided the best example of “how things should be.”  How did they do it?  They increased access to primary care and reduced hospital care.

Todd P. Gilmer, Ph.D.

Todd P. Gilmer, Ph.D. - UCSD

Finally, places that had higher numbers of hospital beds and specialists were associated with higher numbers of hospital admissions while higher numbers of primary care physicians were associated with reduced rates of hospital admissions… Todd P. Gilmer, PhD, professor of health economics in the Department of Family and Preventive Medicine at the University of California – San Diego said, “By looking at service mix, access and price, states can find ways to make their programs work better.”



  1. Leanna Dreiss says:

    Excellent Post,

    The content article provided is useful to help to treat this disease so delicate, like type 1 diabetes …


  2. Thanks for ones marvelous posting! I seriously enjoyed reading it, you can be a great author.I will remember to bookmark your blog and will eventually come back someday. I want to encourage continue your great posts, have a nice holiday weekend!

  3. Wow, this is exactly the kind of blog that I wanted, really good post very helpful information, I have gestational diabetes and I sure this site can be useful for me…

  4. Hello Dear!… I am enjoing your article it is fantastic, the information provided helped me to add some recommendations on my list to try the breast cancer. Thanks for the Info.

  5. Hello, this is exactly the kind of site that I wanted, really nice post very useful info, I have a hepatitis and I sure this site can be useful for me…

  6. I have been exploring for a little for any high-quality articles or blog posts on this kind of area . Exploring in Yahoo I at last stumbled upon this web site. Reading this info So i am happy to convey that I’ve an incredibly good uncanny feeling I discovered just what I needed. I most certainly will make sure to don’t forget this website and give it a glance regularly.

  7. tsul says:

    Here’s the latest on the conference’s top players who are projected to go from playing on Saturdays to starring on Sundays.

    1. LB Jarvis Jones, 6-3, 241, Georgia

    Why he has the top spot: Jones’ battle with an ankle injury hasn’t changed his status as the top overall draft prospect in the SEC. He missed his second full game due to the

    injury in the Bulldogs’ 29-24 win over Kentucky on Saturday. Still, Jones remains a versatile defender who can rush the pass or drop into coverage. He’ll need a strong second

    half of the season to maintain his lofty draft status.

    Season stats (five games): 36 tackles, 5.5 sacks, 9.5 TFLs, 3 forced fumbles, 15 QB hurries, INT.

    Player ranking: Jones remains fifth overall, and he is the second-highest outside linebacker in’s latest player rankings.

    Up next: The Bulldogs’ next game is against Florida. Jones returned to practice on Monday and is expected to play. Georgia will need him against a Florida team that averages 213

    yards per game on the ground.

    2. QB Tyler Wilson, 6-3, 220, Arkansas

    Why he has the second spot: After a slow start for Wilson and the Razorbacks, the senior QB has turned it around in the last few weeks before having a bye last weekend. He’ll

    have a chance to solidify his status as a first-round pick with games against Mississippi State, LSU and South Carolina still on the schedule.

    Season stats (six games): 124 of 205 (60.5 percent) for 1,957 yards, 14 TDs, 5 INTs.

    Player ranking: Wilson is ranked as the No. 12 overall prospect and is the third-highest ranked QB in’s latest player rankings.

    Up next: The Razorbacks play Ole Miss this weekend. The Rebels are ranked No. 65 nationally in scoring defense, so Wilson should have a chance to put some good numbers up.

  8. a4751621 says:

    I’ve said that least 4751621 times. SCK was here

  9. Cartier love says:

    I enjoyed the post. There is some good information here to bookmark.

  10. Very creative, one of the nicer sites I have seen today. Keep up the great work.

  11. Awesome site. Very informative and nice design. I really like your posts and your style.

  12. fototapeta says:

    Thanks for making me to gain new strategies about desktops. I also possess the belief that certain of the best ways to help keep your notebook in leading condition has been a hard plastic-type material case, or maybe shell, that suits over the top of your computer. A lot of these protective gear tend to be model targeted since they are manufactured to fit perfectly over the natural housing. You can buy all of them directly from the owner, or from third party places if they are readily available for your laptop, however only a few laptop can have a spend on the market. Again, thanks for your ideas.

  13. my homepages says:

    I don’t ordinarily comment but I gotta say thank you for the post on this one .

  14. Rumours which E commerce attracts to a close, i’ll tell you the follow-up. Too Hectic To Control E commerce ?

  15. Very nice post. I just stumbled upon your blog and wished to mention that I’ve truly loved surfing around your blog posts. After all I’ll be subscribing for your rss feed and I hope you write once more very soon!

  16. Thanks for your article on this site. From my experience, often times softening right up a photograph may provide the digital photographer with a little an artistic flare. Sometimes however, this soft clouds isn’t just what exactly you had planned and can quite often spoil a normally good photograph, especially if you thinking about enlarging that./wp-login.php?action=registerI have realized that in cameras, extraordinary devices help to target automatically. The particular sensors involving some video cameras change in contrast, while others work with a beam associated with infra-red (IR) light, specifically in low lumination. Higher specification cameras often use a mix of both methods and probably have Face Priority AF where the digital camera can ‘See’ your face while keeping your focus only in that. Thank you for sharing your notions on this blog site./wp-login.php?action=registerThanks for this wonderful article. One more thing to mention is that the majority of digital cameras arrive equipped with any zoom lens that enables more or less of a scene to be included through ‘zooming’ in and out. All these changes in concentration length usually are reflected while in the viewfinder and on substantial display screen right at the back of the particular camera./wp-login.php?action=registerI know of the fact that nowadays, more and more people will be attracted to camcorders and the area of digital photography. However, like a photographer, you will need to first expend so much period deciding the model of photographic camera to buy in addition to moving from store to store just so you can buy the lowest priced camera of the brand you have decided to settle on. But it won’t end now there. You also have to think about whether you should buy a digital camera extended warranty. Many thanks for the good tips I gained from your blog site./wp-login.php?action=registerThanks for your publiction. Another factor is that just being a photographer includes not only difficulties in taking award-winning photographs but hardships in acquiring the best dslr camera suited to your requirements and most especially struggles in maintaining the caliber of your camera. That is very correct and obvious for those photography lovers that are straight into capturing this nature’s interesting scenes — the mountains, the particular forests, the wild and the seas. Visiting these daring places unquestionably requires a dslr camera that can meet the wild’s severe area.

  17. I have to show my passion for your kindness in support of all those that really want help with this particular niche. Your very own commitment to getting the solution all around had become extremely advantageous and have continually encouraged somebody much like me to get to their goals. The warm and friendly help and advice indicates a great deal a person like me and even more to my mates. Thanks a ton; from all of us.

  18. Motory says:

    Fantastic website. Plenty of useful information here. I am sending it to several friends ans also sharing in delicious. And obviously, thanks for your sweat!

  19. Woah! I’m really enjoying the template/theme of this website. It’s simple, yet effective. A lot of times it’s hard to get that “perfect balance” between usability and visual appearance. I must say you have done a very good job with this. Additionally, the blog loads very quick for me on Chrome. Superb Blog!

  20. Just wish to say your article is as amazing. The clarity to your put up is just cool and that i could think you are a professional in this subject. Fine together with your permission let me to grab your RSS feed to keep up to date with coming near near post. Thanks a million and please keep up the gratifying work.

  21. I just couldn’t go away your web site before suggesting that I extremely loved the usual information a person supply for your guests? Is going to be back regularly to check out new posts

  22. Tyron Bence says:

    I precisely desired to say thanks yet again. I do not know the things that I could possibly have used without these pointers revealed by you about such a field. It seemed to be a daunting difficulty for me personally, but encountering this expert way you treated that forced me to weep for delight. I will be thankful for the work and pray you are aware of a great job you have been doing educating some other people thru your site. I am certain you’ve never met all of us.

  23. Hi there very nice website!! Man .. Excellent .. Superb .. I will bookmark your site and take the feeds additionally…I am satisfied to search out a lot of useful info right here in the publish, we want work out more techniques in this regard, thank you for sharing. . . . . .

  24. I in the vein of this web blog same a great deal so a large amount wonderful information.

  25. A huge rebound force on Qiang arm, the Qiang Qiang then suddenly pushed back a homeopathic back window. The injection of compressed air regiment direct hit on the opposite floor window, boom! Loud noise, even with the windows were bombers into the window of the sauce at the end! Incidentally this level building body blown a big hole in the bottom left of the room was a calamity, it looks like by shelling. Qiang originally thought to grab meant little to live on the other side did not think he was too impatient, quick response, directly to the people to destroy.

  26. Qiang certainly will not fall again when the body such as the reaction, in accordance with his plan this time with a flying tigers abnormal changes screwdriver flung across the upstairs, and then pull him over, so he could reach that group of people around, then grab They ask what is the purpose that they shot is Luo instigation or cold blue fox on their own revenge. If it is a Luo people, that the police just arrest people for what they are, Luo people do not even own people together also shot and killed it.

  27. Xu Meng washed five times because the head, so the speed is slow, it would still be dressed in bathrobes, see Liu Yiyi this outfit, he suddenly a lower body, bathrobes are not cover this big tent, so Xu Meng I simply bathrobes fling, Liu Yiyi naked in front of you. Also exceptionally shook showing off their capital.

  28. hello! , Is fantastic composing much! portion most people be in contact further about your post in Yahoo? We will need an experienced during this room to end our issue. It’s possible which is an individual! Looking ahead to see an individual.

  29. Casey Janas says:

    I have been looking for dental care, and this is some good information about a cosmetic dentist in Sacramento.

  30. Learn more of what you need to know check out

  31. James Ledue says:

    I have been searching all over for dental options, and this is some good information about a dentist in Sacramento.

  32. pets says:

    Find more great Here

  33. I’ll be able to use these ideas

  34. sweet tooth says:

    Thank you for another informative website. The place else could I am getting that kind of information written in such a perfect approach?
    I have a undertaking that I am just now working on, and
    I’ve been at the look out for such information.

  35. Online shopping saves you money, the reason why havent you recently been shopping online for your digital camera accessories?. At our Amazon shop cameraprice.usindex.php?c=3356&n=172435&s=pm&p=5&x=Accessories we have found all the offers on amazon and brought them into one store for you personally. We hope that we can fulfill your needs as the holdiays get better. Shop today plus save in our shop online.

  36. Thu Quihuiz says:

    I definitely wanted to send a simple word to be able to say thanks to you for all of the amazing tricks you are sharing on this website. My time consuming internet search has now been compensated with reasonable facts and strategies to write about with my two friends. I ‘d state that that most of us website visitors actually are very much fortunate to dwell in a wonderful place with many lovely individuals with beneficial advice. I feel very fortunate to have encountered the website page and look forward to really more pleasurable moments reading here. Thank you again for all the details. Readmore: Phương pháp xử lí một số trường hợp khi sử dụng máy là đá viên

  37. I must express thanks to this writer just for rescuing me from this type of problem. As a result of scouting through the online world and obtaining recommendations which are not powerful, I believed my life was done. Existing minus the solutions to the problems you have solved all through this guideline is a critical case, and the kind which may have adversely affected my career if I had not come across your blog. The understanding and kindness in touching the whole lot was tremendous. I am not sure what I would’ve done if I hadn’t come upon such a thing like this. I can also now look ahead to my future. Thank you so much for your high quality and result oriented help. I won’t hesitate to endorse your blog to anyone who will need counselling about this subject matter. Readmore: Không gian nội thất cùng màu xanh mòng két

  38. My G, Domino Presley is no doubt the sexiest tranny on the scene!

  39. Nghi Nguyen says:

    I am curious to find out what blog platform you have been working with? I’m experiencing some minor security issues with my latest site and I would like to find something more safe. Do you have any solutions? Please take a look this: Lắp đặt rèm cửa sổ đẹp cho ngôi nhà bạn

  40. ??? ??? says:

    An Disgusting Actuality Relating To Your Lovely japan Desire

  41. Someone essentially help to make seriously articles I might state.
    That is the first time I frequented your website page and to this point?
    I amazed with the analysis you made to create this actual put up incredible.
    Magnificent job!

  42. ??????? says:

    The key reason why nobody is having a debate about watch and the actions one ought to engage in this afternoon.

Leave a Reply