The report, published in the journal Health Affairs, said a study of more than 55,000 colorectal cancer patients found that Medicare beneficiaries in "high spending" areas get better care in some circumstances but worse care in others.

"In certain cases the increased spending is beneficial," Harvard Medical School Professor of health care policy Mary Beth Landrum said Tuesday in a release. "The focus should not simply be on cost containment but rather on targeting care to the patients who we know will benefit."

Landrum and colleagues analyzed the care of colorectal cancer patients in high-spending Medicare areas like Los Angeles and Detroit, low-spending areas such as Iowa, Seattle and Utah and more moderate spending areas like San Francisco and Connecticut.

"For example, chemotherapy for patients in stage 3 colorectal cancer is very helpful and people in these high-spending areas receive it and greatly benefit from it," Landrum said. "But in these high-spending areas doctors also tend to give chemotherapy in other cases where it might do more harm than good, such as with older and sicker patients."