Geographic Variation in Physicians' Responses to a Reimbursement Change

Although much research has revealed U.S. geographic variation in the intensity of health care utilization and the level of Medicare spending,1 such variation in response to Medicare policy changes has received much less attention. This limitation has become more important in the face of the myriad Medicare-reimbursement changes included in the Patient Protection and Affordable Care Act (ACA). We studied the variation in geographic response to a major reform of Medicare's reimbursement system for physician-administered drugs (Part B), the vast majority of which are chemotherapy agents.