Higher Medicare spending yields mixed bag fo...(in these high-spending areas doctors als...),Health

In other words, these results suggest that, when factored together, many of the benefits gained in high-spending areas are offset by an over-use of therapies with dubious beneficial results.

According to co-author Keating, We can make Medicare far more cost-effective not by capping it, but by designing policies that reign in discretionary and nonrecommended therapies, while at the same time supporting all recommended care.

FINDINGS

A large-scale study of over 55,000 colorectal cancer patients found that Medicare beneficiaries in high spending areas get better care in some circumstances, but worse care in others. On net, they do no better than their peers in lower spending areas.

RELEVANCE

Prior studies analyzing Medicare costs and patient outcomes have led some to believe that excess Medicare spending in some areas is wasteful. These findings, however, present a more nuanced picture. Not all care is good, and not all care is bad. As a result, blunt instruments for controlling Medicare costs, as some have suggested, are not likely to be successful.

INVESTIGATORS

Mary Beth Landrum, associate professor of health care policy, Harvard Medical School
http://www.hcp.med.harvard.edu/people/hcp_core_faculty/mary_beth_landrum

Nancy Keating, associate professor of health care policy and medicine, Harvard Medical School
http://www.hcp.med.harvard.edu/people/hcp_core_faculty/nancy_keating

Ellen Meara, assistant professor of health care policy,
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