Attempts to level disparities will likely spur debate

Regarding the article “House provisions would revamp Medicare payment”:

Changing how Medicare reimburses providers in different regions to moderate some of the geographic inequities should be an interesting political debate in Congress. The widely reported disparities brought to light by the Dartmouth Atlas project point out two- or three-fold differences in utilization of Medicare resources per enrollee in different regions, sometimes even within the same state, such as upstate New York compared to New York City. Some is because of higher practice costs but more is because of higher utilization patterns per enrollee.

The higher-utilizing states are for the most part more populous with larger delegations in the House of Representatives. They are not likely to willingly give up any current advantage they have funding their higher utilizing providers and Medicare voters. Those of us in the already efficient states will more likely be asked to further reduce our utilization so that even more of our Medicare payroll taxes can be made available to support higher utilization in the their states.

James Mhyre, M.D.

Comment on today's news or other matters. Submit your comments to the Daily Dialogue at [email protected]. Submissions must include name, title, affiliation, city and state. Modern Healthcare reserves the right to edit all submissions.