A study published in the journal PLOS ONE, examined regional variation in Medicare spending in New York State and found that, while gaps in spending have narrowed over time, substantial variation remains across counties. The study used county-level Medicare spending from 2007–2016 to examine the degree to which high-spending areas remain high-spending in New York State.
Findings from the study:
- Substantial variation exists in per-capita Medicare spending across counties in New York, even after controlling for differences in local prices and health status. In 2016, there was a 34% difference between the lowest- and highest-spending counties ($7,528 in Tompkins compared to $10,063 in Sullivan).
- In general, there was evidence for convergence in spending over time across New York State: counties that were higher-spending in 2007 generally had lower growth rates in spending from 2007 through 2016, and vice versa.
- Even though there was evidence for convergence, a substantial number of counties in were found to be persistently high-spending over time, many of which are located downstate, including Nassau, New York, Orange, Putnam, Rockland, Suffolk, and Westchester counties.
- The services most associated with higher total spending and variation in New York were different from those driving spending trends across the country. Whereas office visits, procedures, imaging, and tests were primary drivers of spending in New York, facility-based care such as inpatient hospital and skilled nursing facility services played a substantially larger role in the rest of the country.
- Convergence in health care spending across counties in New York from 2007 through 2016. PLOS ONE. April 24 2019