New Health Affairs study reexamines cost issues related to care in McAllen and El Paso

Kaiser Health News: "Did McAllen get a bum rap? McAllen, Texas, spends more on Medicare patients than almost any other part of the country. A June 2009 New Yorker article by Atul Gawande attributed the high spending to a culture of doctors that 'came to treat patients the way sub-prime mortgage lenders treated home buyers: as profit centers.' The article became required reading in the White House and Congress during the health care debate and turned McAllen into shorthand for America's decadent medical spending problem." But a Health Affairs study "contradicts one of Gawande's assertions: that McAllen doctors over-treat everyone. The study looked at claims data from the private insurer Blue Cross and Blue Shield of Texas. It found Blue Cross paid McAllen 7 percent less for the care of the average McAllen patient than it did for an average patient in El Paso, 800 miles up the Rio Grande. The New Yorker article repeatedly held up El Paso as an example of a place where medicine is practiced correctly" (Rau, 12/7).

The New Yorker Blog: "A new study introduces a fascinating — and hopeful — wrinkle to the McAllen, Texas, cost conundrum. Health care in McAllen, which I wrote about in the magazine as among the most expensive in America, turns out to be a much better deal for at least some younger and healthier workers. ... Yet can we really extrapolate from the costs of older Medicare patients to all younger ones? After the article was published, Texas Blue Cross Blue Shield gave unusual access to the complete cost files of their members under the age of sixty-five to researchers at the University of Texas School of Public Health and Dartmouth. This week, in the journal Health Affairs, the researchers published their findings. They discovered a shift with age. … Nonetheless, if Blue Cross is succeeding, that means health costs can be malleable — even in one of the most expensive cities for health care. Rationing, in other words, is not our only option. Anyway, there's reason to hope" (Gawande, 12/6).

Dallas Morning News: "The private sector may be about to show whether it's up to the job of curbing the escalating cost of medical care in Dallas. Blue Cross and Blue Shield of Texas is fighting with Texas Health Resources Inc. about cost increases over the next three years. The hospital chain wants a 'modest' increase during a period when it expects to provide more than $3 billion in care for Blue Cross patients. The insurer says that's too much and that it's time for a new approach. … Government programs like Medicare and Medicaid have had little luck putting the brakes on costs with price controls because those controls don't affect the volume of care" (Landers, 12/7).