ANN ARBOR, MI – Anderson, Ind., had the highest per capita healthcare cost for people with commercial health insurance, at $7,231 annually and residents of Odgen-Clearfield, Utah, the lowest at $2,623, according to a new study from Thomson Reuters.
The study – the first of its kind to assess the healthcare experiences and costs for more than 20 million people with employer-sponsored health insurance – found substantial spending disparities similar to those seen in the Medicare population in previous studies, but with different underlying patterns.
[See also: Americans spend more on healthcare than government studies show, Deloitte says]
The study authors cited the McAllen, Texas, metropolitan area as one such example. In numerous studies of Medicare spending, McAllen has been singled out as the highest cost city in the country. The Thomson Reuters research, however, showed it to be one of the 10 least expensive cities in the nation for individuals with employer-sponsored insurance.
"Studying these geographic variations can help us identify locations where healthcare costs are less, yet the quality of care and outcomes are not compromised. Understanding where, why and how medical care costs less can provide solutions to control our nation's healthcare spending," said Ray Fabius, MD, chief medical officer for the Healthcare business of Thomson Reuters and one of the study's authors.
The study found significant variations in spending patterns based on age group and type of expenditure. In Ocala, Fla., healthcare spending for children was 45 percent below the national average while spending for adults was 18 percent above average.
In addition, a common theory in healthcare is that higher outpatient spending would improve overall population health and would lead to lower outlays for inpatient services. Thomson Reuters, however, found that areas with high inpatient costs were also very likely to have high outpatient costs, a finding that puts that theory in question.
"There are some unexpected findings here,” said Bill Marder, senior vice president for research services at Thomson Reuters and lead author. “The bottom line is that it's risky to set policy based solely on Medicare evidence, because we're seeing a different picture when we look at other patient populations. We clearly need to do more in-depth research to better understand how these complex spending variations translate into variations in value for patients."
Thomson Reuters 10 highest spending metropolitan areas:
- Anderson, Ind. $7,231
- Punta Gorda, Fla. $7,168
- Racine, Wis. $6,528
- Naples-Marco Island, Fla. $6,312
- Ocean City, N.J. $6,128
- Barnstable Town, Mass. $6,123
- Flint, Mich. $6,061
- Lake Havasu City-Kingman, Ariz. $5,977
- Ocala, Fla. $5,976
- Carson City, Nev. $5,931
Thomson Reuters 10 lowest spending metropolitan areas:
- Ogden-Clearfield, Utah $2,623
- Dubuque, Iowa $2,719
- Fayetteville-Springdale-Rogers, Ark.-Mo. $2,762
- Fort Smith, Ark.-Okla. $2,916
- Laredo, Texas $2,919
- Amarillo, Texas $2,942
- McAllen-Edinburg-Mission, Texas $2,950
- Salt Lake City, Utah $2,979
- Fargo, N.D. $2,996
- Sioux City, Iowa $3,029
