Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending

A Fresh Look at Regional Health Spending Variation Almost all research on health care spending variation has focused on Medicare, hampering full understanding of what drives variations. Key differences exist between employer-sponsored health insurance and Medicare, making it critical to examine spending variation among privately insured people and not assume that patterns observed in Medicare also occur among the privately insured. This Research Brief examines 2009 data on health care spending and utilization patterns among nonelderly autoworkers represented by the International Union, UAW, and employed by Chrysler, Ford and General Motors—both active workers and retirees—and their dependents (see Data Source). In 2009, the three automakers provided health insurance to more than 1 million people, making them among the largest sources of employersponsored health coverage in the United States. This study focuses on a subset of those covered by the automakers in 2009, namely nonelderly unionized autoworkers—both active and retired—and their dependents who were enrolled in preferred provider organizations, primarily Blue Cross Blue Shield plans. In 2009, autoworker health spending per enrollee varied twofold across the 19 communities studied from a low of $4,500 in Buffalo to a high of $9,000 in Lake County (see Supplementary Table 1). The Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending