Forum Session

Geographic Variation in Health Care Spending: What Do We Know, and Why Does It Matter?
May 21, 2010


Laura A. Dummit


Substantial differences in Medicare spending across the country without corresponding differences in health outcomes have fueled the belief that health care spending can be reduced without harming quality of care. To turn this belief into reality requires providers in high spending areas to practice medicine more like those in lower spending areas. Bringing this about, however, depends on a better understanding of the causes of the variation, the policy levers that could be used to change medical practice, and the potential consequences of using those levers. This Forum session explored what we know about the reasons for geographic differences in health care spending.


Mark Miller, PhD, executive director of the Medicare Payment Advisory Commission (MedPAC), described MedPAC’s analyses of geographic variations. Stephen Zuckerman, PhD, senior fellow at the Urban Institute, presented his latest findings on geographic variations. Gerard Anderson, PhD, professor and director, Center for Hospital Finance and Management, Johns Hopkins Bloomberg School of Public Health, commented on the state of the research on geographic variations and what it means for developing methods to control spending growth.

Slides from the presentations by Dr. Miller, Dr. Zuckerman, and Dr. Anderson are available for download, as are the speakers' biographies.

Related Materials

See also Report to the Congress: Measuring Regional Variation in Service Use (Medicare Payment Advisory Commission (MedPAC), December 2009) and "Clarifying Sources of Geographic Differences in Medicare Spending" (Stephen Zuckerman et al., New England Journal of Medicine, 10.1056/NEJMsa0909253, May 12, 2010; subscription may be required to access link).

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