Rochester, NY, cited for lowest Medicare spending - DC News FOX 5 DC WTTG

Rochester, NY, cited for lowest Medicare spending

Posted: Updated:

MICHAEL VIRTANEN, Associated Press

ALBANY, N.Y. (AP) — A new study finds that the Rochester area has the lowest overall Medicare spending rate in the nation, a feat health officials attribute to aggressive regional planning that keeps a lid on unneeded hospital expansions and technology upgrades that insurers ultimately pay for.

The Institute of Medicine report found that Rochester's Medicare spending rate per beneficiary was $174 lower than the national monthly mean among 306 U.S. regions.

Rochester's success at holding down costs provides a model that Gov. Andrew Cuomo's administration wants to take statewide. Essentially, a standing regional advisory committee made up of various health care stakeholders reviews the need for new departments, new staffing and expensive pieces of equipment and recommends against those that aren't needed in the community.

For example, if an orthopedic practice wanted to buy its own MRI machine and the hospital two blocks away had one that could accommodate those patients, the committee would recommend against it. Insurers can use its recommendations to set reimbursement policies.

Experts say the approach tackles the two biggest drivers of rising medical expenses: new technology and salaries. The idea is that those expensive items have to be paid for somehow and they create a need for health care providers to order up more tests and treatments, the cost of which are ultimately passed on to patients and insurers.

"Supply-driven use of services is one of the major drivers of unwarranted, wasteful health care expenses," said Dr. Martin Lustick, chief corporate medical director for Rochester-based nonprofit insurer Excellus BlueCross BlueShield.

State Health Commissioner Dr. Nirav Shah called Rochester's "a phenomenal model."

"The governor's plan is to do regional planning across New York using Rochester as the example," Shah said. "It's about bringing rationality to the system. It's about adult supervision and not a Wild West. Right now, supply drives demand."

Institute researchers say U.S. health care cost $2.7 trillion in 2011, almost 18 percent of the gross domestic product and higher than other developed countries.

The institute, a nonprofit arm of the National Academy of Sciences, advocates payment reform to push competition toward value rather than toward volume of services, including the Medicare system that covers 39 million people age 65 and older and 8 million with disabilities.

"The chaotic free market health care system costs Americans a bundle," said Blair Horner, legislative director of the New York Public Interest Research Group, adding there would probably be pushback from providers against regional committees limiting their expansion plans. "Rochester offers a way to do it better."

Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

  • Your MoneyMore>>

  • Startups flock to NY TechDay

    Startups flock to NY TechDay

    Thursday, April 24 2014 6:40 PM EDT2014-04-24 22:40:26 GMT
    NY TechDay is where the hottest new startups come every year. More than 400 of them from all different countries come to check out the NYC tech scene. Our first stop at Pier 92 was Rent Hackr, a website with renter generated data to help apartment hunters. Then we checked out Karma, a portable Wi-Fi device that lets you share hot spots with friends.
    NY TechDay is where the hottest new startups come every year. More than 400 of them from all different countries come to check out the NYC tech scene. Our first stop at Pier 92 was Rent Hackr, a website with renter generated data to help apartment hunters. Then we checked out Karma, a portable Wi-Fi device that lets you share hot spots with friends.
  • Studies: office layout can affect your mental and physical health

    Studies: office layout can affect your mental and physical health

    Thursday, April 24 2014 5:13 PM EDT2014-04-24 21:13:30 GMT
    Leaving the office, most of us feel pretty exhausted. Studies now suggest that we can blame much of what ails us physically and mentally on the layout of our workspace. American companies standardized the sprawling square room divided by cubicles or nothing to foster team atmosphere. But newer research suggests that the open-plan office actually raises stress while lowering motivation and focus and maybe even reducing life-expectancy.
    Leaving the office, most of us feel pretty exhausted. Studies now suggest that we can blame much of what ails us physically and mentally on the layout of our workspace. American companies standardized the sprawling square room divided by cubicles or nothing to foster team atmosphere. But newer research suggests that the open-plan office actually raises stress while lowering motivation and focus and maybe even reducing life-expectancy.
  • Cough syrup popular in celebrities' 'sizzurp' cocktails pulled from market

    Cough syrup popular in celebrities' 'sizzurp' cocktails pulled from market

    Thursday, April 24 2014 8:00 AM EDT2014-04-24 12:00:01 GMT
    A prescription cough syrup that some celebrities like to mix with soda and hard candy is being pulled from the market, pharmaceutical company Actavis confirmed. The cough syrup-soda concoction is often called "sizzurp."
    A prescription cough syrup that some celebrities like to mix with soda and hard candy is being pulled from the market, pharmaceutical company Actavis confirmed. The cough syrup-soda concoction is often called "sizzurp."
Powered by WorldNow

WTTG FOX 5 & myfoxdc
5151 Wisconsin Ave. NW
Washington, DC 20016
Main Number: (202) 244-5151
Newsroom: (202) 895-3000
fox5tips@wttg.com

Didn't find what you were looking for?
All content © Copyright 2000 - 2014 Fox Television Stations, Inc. and Worldnow. All Rights Reserved.
Privacy Policy | Terms of Service | Ad Choices