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Higher Medicare spending yields mixed bag for patients
Date:1/7/2008

in these high-spending areas doctors also tend to give chemotherapy in other cases where it might do more harm than good, such as with older and sicker patients. So its an example of spending money in cases where theres little or no benefit.

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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Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
Harvard Medical School
Source:Eurekalert

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