Tag Archives: US Healthcare Spending

41% of healthcare spending attributed to 12% of Americans, study finds

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http://www.beckershospitalreview.com/finance/41-of-healthcare-spending-attributed-to-12-of-americans-study-finds.html

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U.S. adults with five or more chronic conditions spend 14 times more on health services on average than those with no chronic conditions, according to a new RAND Health report prepared for the Partnership to Fight Chronic Disease.

For the study, researchers analyzed the Medical Expenditure Panel Survey from Agency for Healthcare Research and Quality. MEPS is a nationally representative sample of the noninstitutionalized U.S. adult population.

The study revealed 60 percent of U.S. adults had at least one chronic condition in 2014, the most recent year data is available. Forty-two percent of U.S. adults had more than one chronic condition, according to the study.

The study showed people with more chronic conditions require more healthcare services. For example, the study revealed people with five or more chronic conditions average 20 physician visits per year, while those with three or four chronic conditions average 12 physician visits annually.

The study also showed spending on healthcare services rises with the number of chronic conditions a person has. U.S. adults with one or two chronic conditions make up 31 percent of the population and 23 percent of total healthcare spending. Those with five or more chronic conditions make up 12 percent of the population but account for 41 percent of total healthcare spending, according to the study.

For the study, researchers defined healthcare spending as the amount spent on all inpatient and outpatient care across all payers, including out-of-pocket payments.

While Washington Fiddles, Calif. Leaders Forge Ideas For Universal Health Care

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http://khn.org/news/while-washington-fiddles-calif-leaders-forge-ideas-for-universal-health-care/

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As the nation’s Republican leaders huddle to reconsider their plans to “repeal and replace” the nation’s health law, advocates for universal health coverage press on in California, armed with renewed political will and a new set of proposals.

Organized labor and two lawmakers are leading the charge for a single, government-financed program for everyone in the state. Another legislator wants to create a commission that would weigh the best options for a system to cover everyone. And Democratic Lt. Gov. Gavin Newsom, who hopes to become the next governor, has suggested building on employer-based health care to plug holes in existing coverage.

The proposals are fueled both by a fear of losing gains under the Affordable Care Act and a sense that the law doesn’t go far enough toward covering everyone and cutting costs.

But heath policy experts say that creating any type of universal health plan would face enormous political and fiscal challenges — and that if it happens at all, it could take years.

“There are different ways to get there,” says Jonathan Oberlander, professor of social medicine and health policy at the University of North Carolina. “None of them is easy.”

The most specific California proposal comes from state Sens. Ricardo Lara (D-Bell Gardens) and Toni Atkins (D-San Diego), co-authors of legislation that would take steps toward creating one publicly financed “single-payer” program.

The bill, co-sponsored by the California Nurses Association, would aim for something like a system of “Medicare for all” in which the government, not insurers, provides payments and sets coverage rules.

Lara said the approach would get California closer to a system “that covers more and costs less.”

The bill’s authors haven’t announced how the program would be funded. And that’s where the biggest obstacle lies, said Oberlander: It would largely uproot California’s present system, in which roughly half of coverage is sponsored by employers.

If “you’re going to take health insurance largely out of the market, you’re going to disconnect it from employers,” he said. “Then you have to make up all the financing that you’re going to lose.”

There’s no way to make up for those lost employer contributions other than to introduce “very visible taxes,” Oberlander said. And that’s not the only reason why a single payer plan would be controversial. “A lot of people are satisfied with what they have,” he said.

 

Research: Higher U.S. Physician Spending Doesn’t Lead to Better Patient Outcomes

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https://hbr.org/2017/03/research-higher-u-s-physician-spending-doesnt-lead-to-better-patient-outcomes?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+harvardbusiness+%28HBR.org%29

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Health care spending in the United States reached $3.2 trillion in 2013, which accounted for 17% of U.S. GDP. This is almost twice as much as the OECD average of 9%, yet health outcomes in the U.S. are not twice as good as in these other countries. In fact, many outcomes are worse. For example, life expectancy at birth in the U.S. is 78.8 years, which falls short of the OECD average of 80.5 years.

Health care spending also varies substantially within the United States. Many studies have documented enormous geographic variation in spending, finding no clear relationship with quality of care and health outcomes. While some differences in spending and patient outcomes are due to factors outside the health care system, this evidence suggests that there is considerable waste in U.S. health care spending. Many have concluded that at least 20% of spending could be reduced without harming patients.

Geographic regions, however, do not make health care treatment decisions; hospitals, doctors, and patients do. Yet surprisingly few studies have attempted to analyze how health care spending patterns vary for individual doctors, and more important, whether the practice patterns of doctors relate to their patients’ outcomes. Understanding how practice patterns differ among doctors and whether higher-spending doctors have better outcomes is critically important for finding ways to reduce health care costs and improve efficiency of care without harming patients.

In a study recently published in JAMA Internal Medicine, we investigated how spending varies among individual doctors and how spending relates to patient outcomes. We found that individual physicians vary substantially in their health care spending, even within the same hospital, and that greater spending does not lead to improvement in patient outcomes.

 

Health Sector Trend Report, January 2017

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Click to access Altarum%20RWJF%20Trend%20Report%20January%202017.pdf

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These reports, with funding from the Robert Wood Johnson Foundation, provide a monthly summary of key trends in health care spending, prices, utilization, and employment.

They are related to, but distinct from, the Center for Sustainable Health Spending Health Sector Economic Indicators.

The trend reports make direct use of the Quarterly Services Survey (QSS), the timeliest source of detailed, survey-based spending information for health care services, which account for more than 70% of national health spending.

Each quarter, when new QSS data are released (March, June, September, and December), we will publish an expanded version of this report with a more detailed analysis of health care services trends.

The regular monthly reports will supplement the most recent full quarterly analysis with new data on other aspects of health spending, health care prices and utilization, employment and early indications of the trends for the next quarter.

This report provides a monthly summary of key trends in U.S. health care spending, prices, utilization, and employment. The reports build on Altarum’s Health Sector Economic Indicators SM briefs (HSEI) and make direct use of the U.S. Census Bureau’s Quarterly Services Survey (QSS). When new QSS data are released (March, June, September, December), an expanded version of this report is published. Interim reports highlight noteworthy health sector trends and early indications of results for the next quarter. In this January 2017 report, spending estimates are available through November 2016, while prices and labor are available through December 2016.

10 Essential Facts About Medicare’s Financial Outlook

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10 Essential Facts About Medicare’s Financial Outlook

Figure 2: The aging of the population and rising health care costs are contributing to the growth in Medicare spending over time

Medicare, the nation’s federal health insurance program for 57 million people age 65 and over and younger people with disabilities, often plays a major role in federal health policy and budget discussions. This was the case in discussions leading up to enactment of the Affordable Care Act (ACA), which, in addition to expanding health insurance coverage, included changes to Medicare that reduced program spending. Medicare is likely to be back on the federal policy agenda as Congress debates repealing and replacing the ACA, and also if policymakers turn their attention to reducing entitlement spending as part of efforts to reduce the growing federal budget deficit and debt.

By many measures, Medicare’s financial status has improved since the ACA passed in 2010, and repealing the ACA’s provisions related to Medicare would increase program spending and worsen the financial outlook for the program. But even if the Medicare savings and revenue provisions in the ACA are retained, Medicare faces long-term financial pressures associated with higher health care costs and an aging population. To sustain Medicare for the long run, policymakers may need to consider additional program changes to modify program revenues, benefits, spending, and financing.

This brief presents 10 facts and figures about Medicare’s financial status today and the outlook for the future.

Health Spending Projections: 2015-2025

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http://www.chcf.org/publications/2016/12/health-spending-projections?utm_source=CHL&utm_content=From%20The%20Foundation&utm_campaign=Footer

California Health Care Foundation - Health Care That Works for All Californians

National health spending will reach $5.6 trillion by 2025. Get the data on payers, per enrollee costs, payment sources, and spending on types of services.

The Two Mysteries of Medicare

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A growing proportion of Medicare beneficiaries are opting out of the government-run insurance program. They are instead choosing a private plan alternative, one of the Medicare Advantage plans. The strength of this trend defies predictions from the Congressional Budget Office, and nobody can fully explain it.

Here’s another mystery. Traditional Medicare spending growth has slowed, bucking historical trends and expectations. Though there are theories, we don’t fully know what’s causing that either.

Pinning down explanations for these two mysteries is important. Doing so could help us understand the structure and cost of Medicare in the future.

The mysteries may be connected by something that appears, at first, to be unrelated: Doctors and hospitals tend to treat insured patients the same way, regardless of what kind of coverage they have. A traditional Medicare patient admitted to the hospital with, say, pneumonia will receive the same standard of care as a similar but privately insured pneumonia patient.

From this, an idea emerges that links the two mysteries. As enrollment in Medicare Advantage plans grows, so too do the plans’ influence over how doctors and hospitals provide care. Unlike the traditional program, Medicare Advantage plans establish networks, covering care provided only by certain doctors and specific hospitals. Often those are the ones with lower cost growth. As doctors and hospitals reduce their cost growth to gain access to Medicare Advantage networks and the increasing number of patients enrolled in the plans, they do so for traditional Medicare patients as well.

So, as Medicare Advantage enrollment swells, the growth in the cost of care for traditional Medicare falls — a spillover effect. That’s the theory, anyway. Does it hold water?

 

 

Drug prices tug on the economy of healthcare

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http://www.fiercehealthcare.com/finance/drug-prices-tug-economy-healthcare?mkt_tok=eyJpIjoiTmpjd1pURm1NR0ZqTlRWbSIsInQiOiI5MkdaMWJlaGV4dlppeWNkY1NqNTNtTFJ1MFlrcWtQQWxcL2hvYWVUK3lmNEJRT1lCVTJLQTFwdGFcL0dLWWlGMnBzbGNQbXhDdnFDVUdsdkthR3Y4UzJIVm5sT25iNHJmYWd2aGlFXC9ycVNDST0ifQ%3D%3D&mrkid=959610&utm_medium=nl&utm_source=internal

Money Pills

Drug prices continue to bedevil the economics of the U.S. healthcare system in a variety of ways.

Prescription drug prices rose 7 percent between September 2015 and September of this year, according to a new report (.pdf) from the Altarum Institute’s Center for Sustainable Healthcare Spending. No other category rose more than 2.9 percent. Hospital prices rose just 1.2 percent, although that’s up significantly from the 0.7 percent annual increase between September 2014 and September of last year.

Meanwhile, Altarum’s healthcare spending report (PDF) tells a slightly different story. Prescription drug spending rose only at a 4.5 percent annual rate between September 2015 and August of this year. That’s down from the 7.2 percent growth rate from September 2014 to 2015, and the 12.4 percent rate between August 2013 and 2014.

However, hospital spending grew at a 6.6 percent annual rate in September, up from 3.4 percent between September 2014 and 2015. That’s higher than the overall 5.5 percent growth rate.

That dovetails with forecasts that U.S. healthcare spending will reach 20 percent of the gross domestic product (GDP) by the middle of next decade. According to Altarum, it currently amounts to 18.2 percent of GDP. But another report suggested that the Affordable Care Act will actually cut healthcare spending over the long term by $2.6 trillion.

The report, which is closely read by many healthcare policy experts but gains little attention in most media circles, raised some concerns from advocacy groups.