Health care spending in the US is high by global standards; within the US there is considerable geographic variation in spending as well. US health spending is roughly twice as high per capita as other high-income countries, and per capita spending varies 2-fold across hospital referral regions in the US.1-3 There is considerable literature discussing the reasons for international variations. Less well understood and developed are the reasons for geographic variation within countries, including within the US. Much of the descriptive evidence to date on spending variation has focused on specific health conditions or health care markets,4,5 limiting the generalizability of findings, or on spending variation across regions and states,6,7 masking variability within states.

Buntin, M. B., & Liu, A. (2025, February). Understanding Geographic Variation in Health Care Spending. In JAMA Health Forum (Vol. 6, No. 2, pp. e245373-e245373). American Medical Association.