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Medicare spending by state: the border-crossing adjustment.
J Basu1, H C Lazenby, K R Levit
1Office of the Actuary, Health Care Financing Administration, Baltimore, MD 21244, USA.
Health Care Financing Review
|December 4, 1995
Summary
Medicare beneficiaries cross state lines for healthcare services, impacting spending patterns. This study analyzes 1991 expenditure data to understand these border-crossing trends for 10 services.
Area of Science:
- Health economics
- Healthcare utilization
- Medicare research
Background:
- The Health Care Financing Administration (HCFA) initiated efforts to quantify interstate healthcare service utilization.
- Understanding patient movement across state borders is crucial for accurate healthcare expenditure analysis.
Purpose of the Study:
- To analyze the spending behavior of Medicare beneficiaries concerning interstate border crossing for 10 Medicare-covered services.
- To establish a baseline for measuring healthcare service flow across state lines.
Main Methods:
- Utilized interstate flow-of-expenditure data from 1991 for Medicare beneficiaries.
- Analyzed inflow, outflow rates, and netflow ratios of expenditures for state residents.
- Calculated per capita expenditure estimates with residence-based adjustments.
Main Results:
- Quantified interstate spending patterns for Medicare beneficiaries across 10 services.
- Identified significant border-crossing expenditures impacting state-level financial analysis.
- Provided per capita expenditure data adjusted for patient residence.
Conclusions:
- Interstate border crossing is a notable factor in Medicare expenditure analysis.
- The study provides a foundational methodology for HCFA's ongoing measurement efforts.
- Findings highlight the need for state-specific adjustments in healthcare spending assessments.