What do Munster, Ind.; Bradenton, Fla.; and the Big Apple have in common?
Doctors who work in all three communities have sharply increased how often they perform a wide range of operations and tests on Medicare beneficiaries.
When it comes to the greatest overall increase in Medicare procedures and visits, li’l old Munster — which boasts on its municipal website of having "almost 300 doctors" as one of its main business sectors — tops every place in the country.
The average Medicare beneficiary in Munster received 28.7 percent more doctors' services in 2008 than in 2000, according to a Government Accountability Office study. Munster narrowly beat out Manhattan in growth of services. Bradenton was No. 7.
Rounding out the top 10 places with the biggest growth of physician services from 2000 to 2008 were Elgin, Ill.; Covington, Ky.; Petoskey, Mich.; East Long Island, N.Y.; Ormond Beach, Fla.; Royal Oak, Mich., and Kettering, Ohio.
Odessa, Texas, is the only area where the number of Medicare procedures dropped during the period. You can see details — as well as the places with the highest growth in spending — here.
The per-patient increase in major and minor surgeries, office visits and imaging services is one source of the financial strain on Medicare and of the health care system as a whole. But Medicare treatments aren't growing at the same rate everywhere, as we noted in a recent post on how shoulder replacements are 10 times as common in Provo, Utah, as in Syracuse, N.Y.
The GAO report didn’t detail the growth of specific procedures. But a recent study by the Dartmouth Atlas of Health Care, reporting significant increases in rates of joint replacements over a 5-year period ending in 2006, offers some interest tidbits.
The popularity of hip replacements increased fastest in Alexandria, La., doubling over five years. They’re still very infrequent, though. Knee replacements decreased the most in Lawton, Okla., dropping by 35 percent.
Ogden, Utah, replaced the most hips in 2005-2006, giving one of every 75 Medicare beneficiaries a new joint. Bryan, Texas, did the fewest: 1 per 545 people.