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Comment & Response
February 12, 2014

Geographic Differences in US Health Care Spending

Author Affiliations
  • 1McFarland Clinic, Ames, Iowa
JAMA. 2014;311(6):624. doi:10.1001/jama.2013.284303

To the Editor In their Viewpoint regarding the Institute of Medicine (IOM) report on geographic variation in health care spending, Drs Newhouse and Garber1 indicated the spending data were adjusted for geographically different input prices.

Use of a flawed input price–adjustment method leaves many of the IOM report’s conclusions in doubt. The input price adjustment did not use the actual dollars spent on physician work but used geographic practice cost index (GPCI) adjusters to change the spending figures to reflect local differences in input price.2

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