Geographic Variation in Spending and Utilization Across Payer Types

<h2>Overview</h2>
<p>The Dartmouth Institute for Health Policy and Clinical Practice (TDI) has created a publicly available source of data that provides researchers, payers, regulators, and innovators with metrics that quantify temporal and regional patterns of health care spending and utilization in the United States. Using CMS Medicare claims data (mostly for age >64 enrollees), Atlas researchers built cohorts (“denominators”) and numerous measures or events (“numerators”) which were then used to calculate rates either by geography or for patients assigned to specific hospitals. These rates, which are calculated consistently across time and place, provide researchers with opportunities to evaluate spatial and temporal variation/trends. </p>

<p>This entry contains 2017 rates of overall spending (excluding pharmacy claims) and inpatient utilization (measured as bed days per enrollee) across two different insurance payers, fee-for-service Medicare and Medicaid. Rates for a third payer type (private insurers) were also analyzed, but these private insurer rates cannot be posted publicly. Rates are provided for 241 of 306 hospital referral regions (HRRs) and for two states (Vermont and Wyoming). Rates have been adjusted for age and sex. <p>

<p>Users downloading data should review the methods sections of the related
publications for context. All reports in the Dartmouth Atlas of Health Care series are available from the National Library of Medicine <a href="https://www.ncbi.nlm.nih.gov/books/NBK584737/">https://www.ncbi.nlm.nih.gov/books/NBK584737/</a></p>