When 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.
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. - 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.”
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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 CBSSports.com’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 CBSSports.com’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.
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