MedPAC Study: NH Medicare Usage below National Averages
The Medicare Payment Advisory Commission (MedPAC) has released a study showing that the use of Medicare covered Part A and B services in New Hampshire is below the national average throughout the state. Data examined included home care use, as well as hospice, hospital stays, skilled nursing facilities and other services, but MedPAC did not separate out home care as part of its analysis. NH came in at 91% of the national average for the non-metro region and 92% for the Manchester/ Nashua area. Vermont came in at 82% (Burlington area) and 85% (rural), while Maine was at 88-89% for the Portland, Lewiston and rural counties, but 93% in Bangor. Texas, Florida and some of the southern states showed utilization above the national average.
The report points out that regional variation in service use is not equivalent to regional variation in Medicare spending. Regional variation in Medicare spending per beneficiary reflects many factors, including differences in beneficiaries’ health status, Medicare payment rates, service volume (number of services), and service intensity (e.g., MRI versus simple X-ray). By contrast, regional variation in Medicare service use reflects only differences in the volume and intensity of services that beneficiaries with comparable health status receive.
This data is important because policymakers have been examining geographic variation in service use and looking for ways to reduce the “high” number of services provided in certain areas. Geographic variation has gained added significance as Congress grapples with health reform legislation. The recently passed House bill includes a provision requiring the Institute of Medicine to analyze geographic variation in per capita health care spending among Medicare, Medicaid, privately insured, and uninsured populations and to recommend Medicare payment changes by April 15, 2011.