In 1967, John Wennberg began documenting geographic variation in healthcare. In 1988, he founded the Center for Evaluative Clinical Services (CECS) at Dartmouth Medical School. Wennberg's work has shown that patients in regions of the United States that spend more and provide more healthcare services per capita often experience worse outcomes than lower-spending areas that provide less care. Through his research, Wennberg has argued that "the Medicare system could reduce spending by at least 30% while improving the medical care of the most severely ill Americans."