Geographic Issues and Medicare
Marilyn Moon
AcademyHealth
June 28, 2009
®
Medicare Spending per Capita in the
United States, by Hospital Referral Region, 2006
$9,000 to 16,352
8,000 to < 9,000
(57)
(79)
7,500 to < 8,000
7,000 to < 7,500
®
Source: Dartmouth Atlas
(53)
(42)
5,310 to < 7,000
Not Populated
(75)
Variations in End of Life Care,
by State, 2005
State Name
New York
Percent of decedents
ICU/CCU charges per
spending 7 or more
decedent during the
days in ICU/CCU during
last six months of life
the last six months of
(2005)
life (2005)
Hospital days per
decedent during the
last six months of life
(2005)
Reimbursements per
decedent for inpatient
hospitalizations during
the last six months of
life (2005)
12.9
11271.65
15.45
20436.12
New Jersey
23.16
39395.24
15.27
18462.72
California
19.18
19075.35
10.75
17348.73
Michigan
13.27
6885.73
10.82
14649.28
Pennsylvania
15.65
11359.73
11.37
13455.77
Florida
22.62
8088.37
11.5
13328.91
6.84
2877.44
8.09
9769.66
7.8
2893.47
7.21
9176.94
North Dakota
5.29
1729.9
7.56
8963.34
Idaho
5.89
2423.19
5.79
8203.84
Iowa
Montana
®
Source: Dartmouth Atlas
Variation in
Medicare
Reimbursement
by State, 2006
®
Source: Dartmouth Atlas
Variation in
Medicare
Reimbursement
by Hospital
Referral
Region, 2006
®
Source: Dartmouth Atlas
The Relationship Between Quality and
Medicare Spending, by State, 2004
Composite Measure of Quality of Care
88
83
78
73
4,000
5,000
6,000
Spending (Dollars)
®
Source: Data from AHRQ and CMS.
7,000
8,000
Medicaid Eligibility for Working Parents by Income,
January 2008
NH
VT
WA
ND
MT
MN
OR
ID
WI
RI
MI
WY
PA
IA
NE
NV
ILIL
CA
CO
MO
DE
WV
KY
NC
TN
OK
AZ
NM
MD
DC
SC
AR
MS
TX
CT
NJ
OH
IN
VA
KS
MA
NY
SD
UT
ME
AL
GA
LA
AK
FL
HI
US Median Eligibility = 63% FPL
®
20-49% FPL (13 states)
50- 99% FPL (21 states)
100-150% FPL (8 states)
151-275% FPL (9 states including DC)
*The Federal Poverty Level (FPL) for a family of four in 2008 is $21,200 per year.
SOURCE: Survey by the Center on Budget and Policy Priorities for KCMU, 2008.