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Finance and Economics Discussion Series: Data for FEDS Paper 2013-04 ♣

Why the Geographic Variation in Health Care Spending Can't Tell Us Much about the Efficiency or Quality of our Health Care System

Louise Sheiner

Figure 1: Real Spending per Beneficiary and Obesity

state Real medicare acute health spending Obesity
AL 6710.204 28.8
AR 6614.312 26.1
AZ 5528.776 21.2
CA 5395.442 22.2
CO 5412.143 16.8
CT 5354.139 19.7
DE 6164.364 21.1
FL 6755.452 22.9
GA 5890.303 24.7
IA 5888.153 23.5
ID 5396.259 20.8
IL 6200.138 23
IN 6053.566 25.5
KS 6734.875 23.2
KY 6450.525 25.8
LA 7636.171 26.9
MA 5744.961 18.4
MD 7390.245 23.9
ME 5317.181 23.4
MI 6144.443 25.4
MN 5286.255 22.6
MO 6249.036 24.9
MS 7492.79 29.5
MT 5635.718 19.7
NC 5791.088 24.2
ND 5843.282 24.6
NE 5738.38 23.2
NH 4770.684 21.6
NJ 6223.25 21.9
NM 4977.716 21.5
NV 5507.891 21.1
NY 5658.27 22.1
OH 6112.561 25.3
OK 6835.993 24.9
OR 5091.024 21.2
PA 6143.418 24.3
RI 5323.057 19
SC 6072.527 25.1
SD 5700.227 23.8
TN 5907.015 27.2
TX 6776.503 25.8
UT 4510.579 20.4
VA 5485.205 23.1
VT 4765.686 18.7
WA 4842.633 22.2
WI 5426.344 23.2
WV 6724.206 27.6
WY 5900.232 20.8
Return to Figure 1

Figure 2: Adjusted and Unadjusted Medicare Spending

state adjusted log medicare log acute medicare spending
AL 8.646253 8.699015
AR 8.70582 8.654169
AZ 8.697312 8.64787
CA 8.706362 8.792702
CO 8.713228 8.621373
CT 8.654363 8.807771
DE 8.710972 8.815073
FL 8.623959 8.844913
GA 8.658747 8.706986
IA 8.612728 8.549273
ID 8.701128 8.497398
IL 8.691842 8.776167
IN 8.67041 8.675564
KS 8.758813 8.718009
KY 8.695157 8.676416
LA 8.750096 8.875566
MA 8.750558 8.828494
MD 8.721165 8.925454
ME 8.69179 8.540323
MI 8.776612 8.814776
MN 8.685514 8.624791
MO 8.732491 8.711773
MS 8.685113 8.747034
MT 8.70164 8.526549
NC 8.605182 8.671458
ND 8.711311 8.591187
NE 8.722911 8.675393
NH 8.651446 8.571492
NJ 8.695145 8.912474
NM 8.59739 8.461469
NV 8.715993 8.716536
NY 8.7525 8.882253
OH 8.700814 8.726806
OK 8.702889 8.721602
OR 8.646309 8.581857
PA 8.662193 8.776938
RI 8.637987 8.681351
SC 8.678624 8.695004
SD 8.619476 8.555067
TN 8.639313 8.684063
TX 8.727198 8.827908
UT 8.706774 8.468423
VA 8.5324 8.600615
VT 8.717766 8.533657
WA 8.629494 8.5923
WI 8.681699 8.580731
WV 8.712448 8.703009
WY 8.658072 8.558335
Return to Figure 2

Figure 3: Social Capital and Medicare Spending

state real medicare acute spending social capital
AL 6710.204 -1.07
AR 6614.312 -0.5
AZ 5528.776 0.06
CA 5395.442 -0.18
CO 5412.143 0.41
CT 5354.139 0.27
DE 6164.364 -0.01
FL 6755.452 -0.47
GA 5890.303 -1.15
IA 5888.153 0.98
ID 5396.259 0.07
IL 6200.138 -0.22
IN 6053.566 -0.08
KS 6734.875 0.38
KY 6450.525 -0.79
LA 7636.171 -0.99
MA 5744.961 0.22
MD 7390.245 -0.26
ME 5317.181 0.53
MI 6144.443 0
MN 5286.255 1.32
MO 6249.036 0.1
MS 7492.79 -1.17
MT 5635.718 1.29
NC 5791.088 -0.82
ND 5843.282 1.71
NE 5738.38 1.15
NH 4770.684 0.77
NJ 6223.25 -0.4
NM 4977.716 -0.35
NV 5507.891 -1.43
NY 5658.27 -0.36
OH 6112.561 -0.18
OK 6835.993 -0.16
OR 5091.024 0.57
PA 6143.418 -0.19
RI 5323.057 -0.06
SC 6072.527 -0.88
SD 5700.227 1.69
TN 5907.015 -0.96
TX 6776.503 -0.55
UT 4510.579 0.5
VA 5485.205 -0.32
VT 4765.686 1.42
WA 4842.633 0.65
WI 5426.344 0.59
WV 6724.206 -0.83
WY 5900.232 0.67
Return to Figure 3

Figure 4: Social Capital and Measure of State Health and Race

state obese black socialcapital
AL 28.8 0.26 -1.07
AR 26.1 0.16 -0.5
AZ 21.2 0.04 0.06
CA 22.2 0.07 -0.18
CO 16.8 0.04 0.41
CT 19.7 0.1 0.27
DE 21.1 0.2 -0.01
FL 22.9 0.16 -0.47
GA 24.7 0.29 -1.15
IA 23.5 0.02 0.98
ID 20.8 0.01 0.07
IL 23 0.15 -0.22
IN 25.5 0.09 -0.08
KS 23.2 0.06 0.38
KY 25.8 0.08 -0.79
LA 26.9 0.33 -0.99
MA 18.4 0.07 0.22
MD 23.9 0.29 -0.26
ME 23.4 0.01 0.53
MI 25.4 0.14 0
MN 22.6 0.04 1.32
MO 24.9 0.11 0.1
MS 29.5 0.37 -1.17
MT 19.7 0.01 1.29
NC 24.2 0.22 -0.82
ND 24.6 0.01 1.71
NE 23.2 0.04 1.15
NH 21.6 0.01 0.77
NJ 21.9 0.14 -0.4
NM 21.5 0.03 -0.35
NV 21.1 0.08 -1.43
NY 22.1 0.17 -0.36
OH 25.3 0.12 -0.18
OK 24.9 0.08 -0.16
OR 21.2 0.02 0.57
PA 24.3 0.11 -0.19
RI 19 0.06 -0.06
SC 25.1 0.29 -0.88
SD 23.8 0.01 1.69
TN 27.2 0.17 -0.96
TX 25.8 0.12 -0.55
UT 20.4 0.01 0.5
VA 23.1 0.2 -0.32
VT 18.7 0.01 1.42
WA 22.2 0.04 0.65
WI 23.2 0.06 0.59
WV 27.6 0.03 -0.83
WY 20.8 0.01 0.67
Return to Figure 4

Figure 5: Medicare and non-Medicare Spending

state Non_medicare Acute spending Medicare Acute MEPS health insurance premium
AL 2753.689 5997 3414
AR 2725.152 5734 3250
AZ 2401.417 5698 3438
CA 2716.859 6586 3534
CO 2963.537 5549 3684
CT 3209.652 6686 3864
DE 3579.868 6735 3830
FL 2833.546 6939 3807
GA 2654.426 6045 3335
IA 3219.201 5163 3561
ID 2614.246 4902 3429
IL 3106.262 6478 3768
IN 3079 5858 3586
KS 3148.27 6112 3711
KY 3148.207 5863 3542
LA 2748.501 7155 3485
MA 3776.935 6826 4141
MD 3148.64 7521 3721
ME 3908.557 5117 4116
MI 2781.429 6733 3918
MN 3391.462 5568 3809
MO 3172.034 6074 3559
MS 2817.326 6292 3607
MT 3253.097 5047 3680
NC 2834.062 5834 3551
ND 3458.068 5384 3342
NE 3367.995 5857 3725
NH 3166.683 5279 4084
NJ 2967.214 7424 3882
NM 2644.144 4729 3401
NV 2670.57 6103 3874
NY 3317.262 7203 3858
OH 3260.959 6166 3782
OK 2765.146 6134 3644
OR 2955.775 5334 3706
PA 3170.641 6483 3671
RI 3239.756 5892 4368
SC 2971.537 5973 3773
SD 3353.093 5193 3449
TN 3121.135 5908 3634
TX 2698.338 6822 3781
UT 2330.074 4762 3034
VA 2835.994 5435 3865
VT 3746.73 5083 4074
WA 3103.036 5390 3608
WI 3576.771 5328 3927
WV 3509.168 6021 3692
WY 3483.101 5210 3761
Return to Figure 5

Figure 6: Ratio of per-beneficiary Medicare acute to per-beneficiary non-Medicare acute Spending

state Ratio Medicare to Non-Medicare Uninsured Black
AL 2.177806 12.5 0.26
AR 2.104103 16.2 0.16
AZ 2.372766 16.7 0.04
CA 2.424123 18 0.07
CO 1.872425 15.9 0.04
CT 2.083092 10.9 0.1
DE 1.881354 13.3 0.2
FL 2.448875 19.4 0.16
GA 2.277328 16.9 0.29
IA 1.603814 9.2 0.02
ID 1.87511 14.5 0.01
IL 2.085465 13 0.15
IN 1.902566 13.8 0.09
KS 1.941384 10.7 0.06
KY 1.86233 13.6 0.08
LA 2.603237 16 0.33
MA 1.807286 11.3 0.07
MD 2.38865 13.4 0.29
ME 1.309179 8.9 0.01
MI 2.420698 11.1 0.14
MN 1.64177 8.5 0.04
MO 1.91486 11.9 0.11
MS 2.233323 16.7 0.37
MT 1.551445 18.2 0.01
NC 2.058529 14.8 0.22
ND 1.556939 10.1 0.01
NE 1.739017 10.4 0.04
NH 1.667044 10.1 0.01
NJ 2.50201 13.9 0.14
NM 1.788481 19.8 0.03
NV 2.28528 18.4 0.08
NY 2.171369 12.6 0.17
OH 1.890855 10.6 0.12
OK 2.218328 19.2 0.08
OR 1.804603 16.3 0.02
PA 2.044697 10.9 0.11
RI 1.818655 10.3 0.06
SC 2.010071 14.8 0.29
SD 1.548719 11.2 0.01
TN 1.892901 13.1 0.17
TX 2.528223 24.2 0.12
UT 2.043712 13.3 0.01
VA 1.916436 13.4 0.2
VT 1.35665 10.5 0.01
WA 1.737009 12.4 0.04
WI 1.489612 10.1 0.06
WV 1.715791 16.1 0.03
WY 1.495793 12.8 0.01
Return to Figure 6

Figure 7: Quality Rankings and Health Spending

state Quality Ranking Non-Medicare acute Medicare Acute
AL 42 2753.689 5997
AR 48 2725.152 5734
AZ 29 2401.417 5698
CA 44 2716.859 6586
CO 7 2963.537 5549
CT 9 3209.652 6686
DE 14 3579.868 6735
FL 41 2833.546 6939
GA 47 2654.426 6045
IA 6 3219.201 5163
ID 22 2614.246 4902
IL 46 3106.262 6478
IN 27 3079 5858
KS 30 3148.27 6112
KY 40 3148.207 5863
LA 51 2748.501 7155
MA 15 3776.935 6826
MD 25 3148.64 7521
ME 3 3908.557 5117
MI 26 2781.429 6733
MN 10 3391.462 5568
MO 28 3172.034 6074
MS 50 2817.326 6292
MT 13 3253.097 5047
NC 23 2834.062 5834
ND 4 3458.068 5384
NE 12 3367.995 5857
NH 1 3166.683 5279
NJ 43 2967.214 7424
NM 36 2644.144 4729
NV 35 2670.57 6103
NY 24 3317.262 7203
OH 38 3260.959 6166
OK 45 2765.146 6134
OR 11 2955.775 5334
PA 31 3170.641 6483
RI 17 3239.756 5892
SC 32 2971.537 5973
SD 20 3353.093 5193
TN 39 3121.135 5908
TX 49 2698.338 6822
UT 5 2330.074 4762
VA 18 2835.994 5435
VT 2 3746.73 5083
WA 19 3103.036 5390
WI 8 3576.771 5328
WV 34 3509.168 6021
WY 21 3483.101 5210
Return to Figure 7

Figure 8: Relationship between Adjusted and Unadjusted Medicare Spending and Quality

state Quality Ranking Log Real Medicare Acute Adjusted Log Real Medicare Acute
AL 42 8.699015 8.646253
AR 48 8.654169 8.70582
AZ 29 8.64787 8.697312
CA 44 8.792702 8.706362
CO 7 8.621373 8.713228
CT 9 8.807771 8.654363
DE 14 8.815073 8.710972
FL 41 8.844913 8.623959
GA 47 8.706986 8.658747
IA 6 8.549273 8.612728
ID 22 8.497398 8.701128
IL 46 8.776167 8.691842
IN 27 8.675564 8.67041
KS 30 8.718009 8.758813
KY 40 8.676416 8.695157
LA 51 8.875566 8.750096
MA 15 8.828494 8.750558
MD 25 8.925454 8.721165
ME 3 8.540323 8.69179
MI 26 8.814776 8.776612
MN 10 8.624791 8.685514
MO 28 8.711773 8.732491
MS 50 8.747034 8.685113
MT 13 8.526549 8.70164
NC 23 8.671458 8.605182
ND 4 8.591187 8.711311
NE 12 8.675393 8.722911
NH 1 8.571492 8.651446
NJ 43 8.912474 8.695145
NM 36 8.461469 8.59739
NV 35 8.716536 8.715993
NY 24 8.882253 8.7525
OH 38 8.726806 8.700814
OK 45 8.721602 8.702889
OR 11 8.581857 8.646309
PA 31 8.776938 8.662193
RI 17 8.681351 8.637987
SC 32 8.695004 8.678624
SD 20 8.555067 8.619476
TN 39 8.684063 8.639313
TX 49 8.827908 8.727198
UT 5 8.468423 8.706774
VA 18 8.600615 8.5324
VT 2 8.533657 8.717766
WA 19 8.5923 8.629494
WI 8 8.580731 8.681699
WV 34 8.703009 8.712448
WY 21 8.558335 8.658072
Return to Figure 8

Figure 9: Medicare Spending Growth

state Medicare Acute 2004 Medicare Acute 1991 Growth Rate 1991-2004
AL 5997 3071.344 0.0528204
AR 5734 2953.424 0.0523592
AZ 5698 3261.379 0.0438548
CA 6586 3649.337 0.0464625
CO 5549 2793.055 0.0542254
CT 6686 3306.585 0.0556551
DE 6735 3648.19 0.0482903
FL 6939 3347.974 0.057663
GA 6045 3216.663 0.0497266
IA 5163 2602.377 0.0541128
ID 4902 2267.274 0.061107
IL 6478 3223.895 0.0551454
IN 5858 2765.427 0.059439
KS 6112 2934.279 0.058069
KY 5863 2923.9 0.0549767
LA 7155 3693.639 0.0521771
MA 6826 3654.34 0.0492371
MD 7521 3826.767 0.0533497
ME 5117 2487.206 0.0570616
MI 6733 3273.048 0.0570527
MN 5568 2654.496 0.058638
MO 6074 3019.222 0.0552425
MS 6292 2871.518 0.0621991
MT 5047 2508.553 0.0552482
NC 5834 2656.742 0.0623759
ND 5384 2490.407 0.0611005
NE 5857 2460.715 0.0689818
NH 5279 2578.352 0.0566695
NJ 7424 3471.777 0.0602084
NM 4729 2531.35 0.0492482
NV 6103 3108.865 0.053256
NY 7203 3606.927 0.0546439
OH 6166 3120.155 0.0537946
OK 6134 2896.254 0.0594239
OR 5334 2544.08 0.0586015
PA 6483 4089.649 0.0360758
RI 5892 3058.985 0.0517169
SC 5973 2519.747 0.0686451
SD 5193 2471.831 0.058766
TN 5908 2875.818 0.0569446
TX 6822 3029.402 0.0644361
UT 4762 2320.514 0.0568559
VA 5435 2868.445 0.0503892
VT 5083 2421.633 0.0586932
WA 5390 2843.122 0.0504339
WI 5328 2580.603 0.0573498
WV 6021 2884.582 0.0582384
WY 5210 2583.31 0.0554447
Return to Figure 9

Appendix Figure 1A: State-specific factor affects both diabetes and smoking 1B: State-specific factor affects only diabetes.

state cigarettes diabetes mncig mndiab cigarettes (only diabetes) diabetes (only diabetes) mncig (only diabetes) mndaib (only diabetes)
1 3.82 0.8 4.11 1.525 1.12 0.3 1.41 1.025
1 3.84 0.85 4.11 1.525 1.14 0.35 1.41 1.025
1 3.86 0.9 4.11 1.525 1.16 0.4 1.41 1.025
1 3.88 0.95 4.11 1.525 1.18 0.45 1.41 1.025
1 3.9 1 4.11 1.525 1.2 0.5 1.41 1.025
1 3.92 1.05 4.11 1.525 1.22 0.55 1.41 1.025
1 3.94 1.1 4.11 1.525 1.24 0.6 1.41 1.025
1 3.96 1.15 4.11 1.525 1.26 0.65 1.41 1.025
1 3.98 1.2 4.11 1.525 1.28 0.7 1.41 1.025
1 4 1.25 4.11 1.525 1.3 0.75 1.41 1.025
1 4.02 1.3 4.11 1.525 1.32 0.8 1.41 1.025
1 4.04 1.35 4.11 1.525 1.34 0.85 1.41 1.025
1 4.06 1.4 4.11 1.525 1.36 0.9 1.41 1.025
1 4.08 1.45 4.11 1.525 1.38 0.95 1.41 1.025
1 4.1 1.5 4.11 1.525 1.4 1 1.41 1.025
1 4.12 1.55 4.11 1.525 1.42 1.05 1.41 1.025
1 4.14 1.6 4.11 1.525 1.44 1.1 1.41 1.025
1 4.16 1.65 4.11 1.525 1.46 1.15 1.41 1.025
1 4.18 1.7 4.11 1.525 1.48 1.2 1.41 1.025
1 4.2 1.75 4.11 1.525 1.5 1.25 1.41 1.025
1 4.22 1.8 4.11 1.525 1.52 1.3 1.41 1.025
1 4.24 1.85 4.11 1.525 1.54 1.35 1.41 1.025
1 4.26 1.9 4.11 1.525 1.56 1.4 1.41 1.025
1 4.28 1.95 4.11 1.525 1.58 1.45 1.41 1.025
1 4.3 2 4.11 1.525 1.6 1.5 1.41 1.025
1 4.32 2.05 4.11 1.525 1.62 1.55 1.41 1.025
1 4.34 2.1 4.11 1.525 1.64 1.6 1.41 1.025
1 4.36 2.15 4.11 1.525 1.66 1.65 1.41 1.025
1 4.38 2.2 4.11 1.525 1.68 1.7 1.41 1.025
1 4.4 2.25 4.11 1.525 1.7 1.75 1.41 1.025
2 5.56 1.4 5.85 2.125 1.24 0.6 1.53 1.325
2 5.58 1.45 5.85 2.125 1.26 0.65 1.53 1.325
2 5.6 1.5 5.85 2.125 1.28 0.7 1.53 1.325
2 5.62 1.55 5.85 2.125 1.3 0.75 1.53 1.325
2 5.64 1.6 5.85 2.125 1.32 0.8 1.53 1.325
2 5.66 1.65 5.85 2.125 1.34 0.85 1.53 1.325
2 5.68 1.7 5.85 2.125 1.36 0.9 1.53 1.325
2 5.7 1.75 5.85 2.125 1.38 0.95 1.53 1.325
2 5.72 1.8 5.85 2.125 1.4 1 1.53 1.325
2 5.74 1.85 5.85 2.125 1.42 1.05 1.53 1.325
2 5.76 1.9 5.85 2.125 1.44 1.1 1.53 1.325
2 5.78 1.95 5.85 2.125 1.46 1.15 1.53 1.325
2 5.8 2 5.85 2.125 1.48 1.2 1.53 1.325
2 5.82 2.05 5.85 2.125 1.5 1.25 1.53 1.325
2 5.84 2.1 5.85 2.125 1.52 1.3 1.53 1.325
2 5.86 2.15 5.85 2.125 1.54 1.35 1.53 1.325
2 5.88 2.2 5.85 2.125 1.56 1.4 1.53 1.325
2 5.9 2.25 5.85 2.125 1.58 1.45 1.53 1.325
2 5.92 2.3 5.85 2.125 1.6 1.5 1.53 1.325
2 5.94 2.35 5.85 2.125 1.62 1.55 1.53 1.325
2 5.96 2.4 5.85 2.125 1.64 1.6 1.53 1.325
2 5.98 2.45 5.85 2.125 1.66 1.65 1.53 1.325
2 6 2.5 5.85 2.125 1.68 1.7 1.53 1.325
2 6.02 2.55 5.85 2.125 1.7 1.75 1.53 1.325
2 6.04 2.6 5.85 2.125 1.72 1.8 1.53 1.325
2 6.06 2.65 5.85 2.125 1.74 1.85 1.53 1.325
2 6.08 2.7 5.85 2.125 1.76 1.9 1.53 1.325
2 6.1 2.75 5.85 2.125 1.78 1.95 1.53 1.325
2 6.12 2.8 5.85 2.125 1.8 2 1.53 1.325
2 6.14 2.85 5.85 2.125 1.82 2.05 1.53 1.325
3 7.3 2 7.59 2.725 1.36 0.9 1.65 1.625
3 7.32 2.05 7.59 2.725 1.38 0.95 1.65 1.625
3 7.34 2.1 7.59 2.725 1.4 1 1.65 1.625
3 7.36 2.15 7.59 2.725 1.42 1.05 1.65 1.625
3 7.38 2.2 7.59 2.725 1.44 1.1 1.65 1.625
3 7.4 2.25 7.59 2.725 1.46 1.15 1.65 1.625
3 7.42 2.3 7.59 2.725 1.48 1.2 1.65 1.625
3 7.44 2.35 7.59 2.725 1.5 1.25 1.65 1.625
3 7.46 2.4 7.59 2.725 1.52 1.3 1.65 1.625
3 7.48 2.45 7.59 2.725 1.54 1.35 1.65 1.625
3 7.5 2.5 7.59 2.725 1.56 1.4 1.65 1.625
3 7.52 2.55 7.59 2.725 1.58 1.45 1.65 1.625
3 7.54 2.6 7.59 2.725 1.6 1.5 1.65 1.625
3 7.56 2.65 7.59 2.725 1.62 1.55 1.65 1.625
3 7.58 2.7 7.59 2.725 1.64 1.6 1.65 1.625
3 7.6 2.75 7.59 2.725 1.66 1.65 1.65 1.625
3 7.62 2.8 7.59 2.725 1.68 1.7 1.65 1.625
3 7.64 2.85 7.59 2.725 1.7 1.75 1.65 1.625
3 7.66 2.9 7.59 2.725 1.72 1.8 1.65 1.625
3 7.68 2.95 7.59 2.725 1.74 1.85 1.65 1.625
3 7.7 3 7.59 2.725 1.76 1.9 1.65 1.625
3 7.72 3.05 7.59 2.725 1.78 1.95 1.65 1.625
3 7.74 3.1 7.59 2.725 1.8 2 1.65 1.625
3 7.76 3.15 7.59 2.725 1.82 2.05 1.65 1.625
3 7.78 3.2 7.59 2.725 1.84 2.1 1.65 1.625
3 7.8 3.25 7.59 2.725 1.86 2.15 1.65 1.625
3 7.82 3.3 7.59 2.725 1.88 2.2 1.65 1.625
3 7.84 3.35 7.59 2.725 1.9 2.25 1.65 1.625
3 7.86 3.4 7.59 2.725 1.92 2.3 1.65 1.625
3 7.88 3.45 7.59 2.725 1.94 2.35 1.65 1.625
Return to Figure a1
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Last update: April 17, 2013