Rochester, NY, cited for lowest Medicare spending - Los Angeles News | FOX 11 LA KTTV

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>>

  • Dunkin' Donuts cashiers will try to 'upsell' you in the afternoon

    Dunkin' Donuts cashiers will try to 'upsell' you in the afternoon

    Friday, July 25 2014 5:54 AM EDT2014-07-25 09:54:31 GMT
    If an iced coffee from Dunkin' Donuts is part of your afternoon routine, expect a nudge to buy a cookie or doughnut you didn't plan on. Dunkin' Brands CEO Nigel Travis said in a phone interview Thursday that the company is pushing to get its cashiers to "upsell" to afternoon customers. It's part of an effort to increase sales after stores have emptied out after the morning rush.
    If an iced coffee from Dunkin' Donuts is part of your afternoon routine, expect a nudge to buy a cookie or doughnut you didn't plan on. Dunkin' Brands CEO Nigel Travis said in a phone interview Thursday that the company is pushing to get its cashiers to "upsell" to afternoon customers. It's part of an effort to increase sales after stores have emptied out after the morning rush.
  • iPad sales decline

    Are tablets already on their way out?

    Are tablets already on their way out?

    Friday, July 25 2014 5:50 AM EDT2014-07-25 09:50:16 GMT

    Four years ago, tablet owners starting raving about the market's newest piece of mobile technology. Last quarter, Apple iPad sales fell by 9 percent. Still, forecasting the death of the tablet seems premature and incorrect. More likely, all our devices are cross-breeding and evolving until all our calling, emailing, texting, messaging, Internetting, TV watching, all our communication happens on one mobile gadget.


    Four years ago, tablet owners starting raving about the market's newest piece of mobile technology. Last quarter, Apple iPad sales fell by 9 percent. Still, forecasting the death of the tablet seems premature and incorrect. More likely, all our devices are cross-breeding and evolving until all our calling, emailing, texting, messaging, Internetting, TV watching, all our communication happens on one mobile gadget.
  • Cooler inventor raises $7 million in two weeks

    Cooler inventor raises $7 million in two weeks

    Thursday, July 24 2014 11:24 AM EDT2014-07-24 15:24:47 GMT

    What is being described as the coolest cooler of the 21st century is getting a lot of backers via Kickstarter.  Ryan Grepper, an inventor from Portland, Oregon, says he was tired of regular coolers.

    What is being described as the coolest cooler of the 21st century is getting a lot of backers via Kickstarter.  Ryan Grepper, an inventor from Portland, Oregon, says he was tired of regular coolers.

Powered by WorldNow

KTTV FOX 11
1999 S. Bundy Dr.
Los Angeles CA 90025

Main: (310) 584-2000
News Tips? (310) 584-2025

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