In addition, it is thought that better metrics could help to controlcosts. Findings from the Dartmouth medical atlas project show thatin high spending regions of the country, patients receive consis-tently more treatment. For example, Sutherland et al. (2009) foundthat “discretionary decisions by providers seem to account for mostof the regional variation in spending,” and that outcomes were notbetter in high spending areas of the country. The strong implica-tion is that costs could be reduced without sacrificing outcomes byreigning in the discretion of medical providers (Garber and Skinner,2008).