TribBlog: Backtracking On McAllen?

New Yorker writer Atul Gawande put McAllen's medical providers on the defensive in a 2009 article, claiming the region's health care was among the most expensive in the U.S.

In a new blog post last week, Gawande seemed to backtrack — at least in part. It turns out, he said, that a new study shows health care there is a much better deal "for at least some younger and healthier workers."

Gawande's original story found that McAllen's costs for Medicare patients were almost double those of El Paso, despite the two having similar levels of poverty and health. He said data showed McAllen doctors ordering more tests, more procedures, "more everything." His story seemed to indicate these were decisions being driven by doctors' pocketbooks — and decisions affecting patients regardless of age or ethnic group. 

But a new study in the journal Health Affairs, published by researchers at the University of Texas School of Public Health and Dartmouth University, discovered what Gawande calls a "shift with age." "For members fifty or older, McAllen was indeed significantly more expensive than El Paso," he writes. "But for those under fifty, McAllen was downright ordinary — even less costly than El Paso. They had escaped high-cost care." 

The study is good news for Renaissance Hospital, the McAllen flagship hospital that was the subject of Gawande's article and has spent much of the last year defending itself and its doctors from the article's implications.