A Commonwealth Fund study, examining the concentration of traditional Medicare spending within regional health care markets, found that two hospital systems accounted for most of traditional Medicare inpatient hospital spending in more than two-thirds of markets. In 16 states and the District of Columbia, a single hospital system accounts for at least one-quarter of all Medicare inpatient hospital spending.
Using Medicare claims data from 2021 analyzed by CareJourney, a health care analytics company, researchers examined the concentration of traditional Medicare spending within regional health care markets known as hospital referral regions (HRRs). HRRs are geographic areas made up of zip codes and are designed to define health care market regions based on referral patterns of specialized hospital care, like major cardiovascular surgical procedures. The 306 HRRs in the U.S. have boundaries that often cross state lines. Spending data for Medicare Advantage plans, which comprise a large share of beneficiaries in some markets, is not available and therefore excluded from this analysis.
- Which Parts of the United States Have the Most Consolidated Medicare Hospital Spending? The Commonwealth Fund. January 4 2023.