The folks at the Texas-based National Center for Policy Analysis have a new paper out that examines the surprisingly large variations in Medicare costs across the U.S. What accounts for major differences in a federal program that was intended to create nationwide uniformity? From the summary: 

  • Higher Social Security benefits as well as more Supplemental Security Income imply higher spending.
  • Higher percentages of Hispanics and blacks are related to higher average Medicare spending in the counties.
  • Higher
    percentages of female retirees in a county are positively related to
    spending, while higher percentages over age 85 are negatively related.
  • Higher
    health care sector wages are associated with lower Medicare spending,
    but managed care penetration has a positive effect on spending.
  • The
    most important factors are the health risks among a county’s Medicare
    beneficiaries which are (as expected) associated with higher spending.
  • The
    observable county characteristics along with a measure of the health
    care risks explains about 40 percent of the variation in average
    Medicare spending across the counties in the continental United States. 

The report doesn’t specifically list North Carolina’s average Medicare costs. It contains a host of nationwide graphs grouping expenditure by county. Eyeballing them, it sure looks like NC costs are somewhat below-average. The report does list the top-10 spending states and the bottom-ten spending states. Neighboring Virginia is clearly in the latter quintile.

Interesting, since NC appears to have a relatively expensive Medicaid program.