title: Regional Growth in Medicare Spending, 1992-2010.
abstract: OBJECTIVE
  To determine if regions with high Medicare expenditures in a given setting remain high cost over time.
  
  
  METHODS
  One hundred percent of national Medicare Parts A and B fee-for-service beneficiary claims data and enrollment for 1992-2010.
  
  
  METHODS
  Patients are classified into regions. Claims are price-standardized. Risk adjustment is performed at the beneficiary level using the CMS Hierarchical Condition Categories model. Correlation analyses are conducted.
  
  
  METHODS
  The data were obtained through a contract with CMS for a study performed for the Institute of Medicine.
  
  
  RESULTS
  High-cost regions in 1992 are likely to remain high cost in 2010. Stability in regional spending is highest in the home health, inpatient hospital, and outpatient hospital settings over this time period. Despite the persistence of a region's relative spending over time, a region's spending levels in all settings except home health tend to regress toward the mean.
  
  
  CONCLUSIONS
  Relatively high-cost regions tend to remain so over long periods of time, even after controlling for patient health status and geographic price variation, suggesting that the observed effect reflects real differences in practice patterns.
authors: Departments of Mathematics and Religion, Williams College, Acumen, LLC and SPHERE Institute, Burlingame, CA.
authors: Camille
authors: C
authors: Chicklis
authors: Department of Economics, University of Chicago, Acumen, LLC and SPHERE Institute, Burlingame, CA.|Department of Economics, University of Washington, Acumen, LLC and SPHERE Institute, Burlingame, CA.
authors: Thomas
authors: T
authors: MaCurdy
authors: Department of Economics, Stanford University School of Medicine, Stanford University, Stanford, CA.
authors: Jay
authors: J
authors: Bhattacharya
authors: Department of Economics, University of California, San Diego, La Jolla, CA.|Department of Business and Policy, Wharton School, University of Pennsylvania, Philadelphia, PA.|Spanish Department, School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA.|Precision Health Economics, Los Angeles, CA.
authors: Jason
authors: J
authors: Shafrin
authors: Princeton Department of Economics, Acumen, LLC, Burlingame, CA.
authors: Sajid
authors: S
authors: Zaidi
authors: Departments of Economics and Mathematics, University of California, Berkeley, Acumen, LLC, Burlingame, CA.
authors: Daniel
authors: D
authors: Rogers
mesh_terms: D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D017051:Hospice Care / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D020379:Risk Adjustment; D012866:Skilled Nursing Facilities / Q000191:economics / Q000706:statistics & numerical data; D014481:United States
keywords: Medicare fee-for-service; Medicare spending