Wennberg on Practice Variations in California

Here's a Web Exclusive from Health Affairs:

John E. Wennberg of the Dartmouth Center for Evaluative Clinical Sciences, finds that Medicare spent far more in the last two years of life for enrollees treated in Los Angeles hospitals than it did in Sacramento hospitals, indicating the presence of vast variations in how providers in the two metropolitan areas treat patients. Wennberg and colleagues examined claims data for chronically ill Medicare beneficiaries in California who died during 1999-2003, to develop a picture of health care resource utilization patterns in California hospitals. LA hospitals on average received 69 percent more per Medicare patient treated in the last two years of life than did Sacramento hospitals, which the authors used as the state's benchmark for spending. Medicare could have saved $1.7 billion had the per person spending been the same in LA as in Sacramento over the study period.

Accompanying Wennberg's paper are perspectives by Sen. Max Baucus (D-MT); Thomas Priselac, president and chief executive officer of Cedars-Sinai Health System in Los Angeles; Uwe Reinhardt, James Madison Professor of Political Economy at Princeton University; Leonard Schaeffer, chairman of WellPoint, and Dana McMurtry, WellPoint's vice president for public policy; and Barry Straube, acting director of the Office of Clinical Standards and Quality and acting chief medical officer of the Centers for Medicare and Medicaid Services (CMS).

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