The AHA report—called “Geographic Variation in Health Care Spending: A Closer Look—asserts that the most relied upon source for regional spending data, the Dartmouth Atlas of Health Care, fails to reflect that a “complex interplay of variables influences an area's level of spending” and that “policy proposals that fail to account for these complexities could create unintended consequences for providers and communities.”
Citing the Medicare Payment Advisory Committee, the report asserts that spending variation is less pronounced when adjusted for federal support for graduate medical education and disproportionate-share payments. Utilization, the AHA report argues, is driven by factors not adequately addressed in the Dartmouth Atlas data, such as the prevalence of chronic illnesses; diabetes; demographics; and the number of people are uninsured and more likely to have health problems when they become Medicare beneficiaries.
The AHA report also touches on the role of local practice environments, medical-malpractice award caps and private payers, and questions the conclusion of the Dartmouth Atlas that higher spending does not correlate with higher quality.
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