LAUSR

Key Points Question How much variation in Medicare per beneficiary spending across counties was associated with social determinants of health (SDoH)? Findings In this cross-sectional study, SDoH were associated with 37.7% of variation in price-adjusted Medicare per beneficiary spending between counties in the highest and lowest quintiles of spending in 2017, including both direct contributions and indirect contributions through other factors. SDoH’s direct contribution accounted for 5.8% of the variation after controlling for patient demographic characteristics, clinical risk, and supply of health care resources. Meaning These findings suggest that addressing SDoH is important for reducing geographic spending variation and improving the value of health care.