Understanding US Health Care Spending

Posted on July 26, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Dear ME-P Colleagues,

Nancy Chockley, President and CEO

The NIHCM Foundation is pleased to announce the release of a new data brief, Understanding U.S. Health Care Spending.

In it, we examine why we spend more than $8,000 per person on health care and the factors driving spending growth. Our analysis documents the extreme concentration of expenditures, with just 5 percent of the population responsible for almost half of all spending, and demonstrate the importance of rising spending for hospital and physician services as the primary drivers of expenditure growth.

Findings are based on NIHCM analysis of the most recent data from the National Health Expenditure Accounts and the Medical Expenditure Panel Survey.

We hope that you find this publication helpful for your own work.

Sincerely,
Julie Schoenman [Director of Research and Development]

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On Physicians’ Responses to Payment Changes‏

Posted on November 30, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Expect the Unexpected?

By Nancy Chockley, PhD
President & CEO
National Institute for Health Care Management

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Across the Blogosphere – Expert Voices

Reducing unit prices is one possible weapon in the battle to stem rising health care spending, but this approach can have unintended consequences if utilization increases by more than prices have fallen.

Current Essay on Medicare Drug Payment Reductions

In his essay, Dr. Jacobson and Dr. Newhouse present findings from their recent research on how physicians have responded to reductions in Medicare payments for chemotherapy drugs. Their work documents an increase in chemotherapy use rates and a switch from the drugs whose reimbursement declined to a drug that offered a higher profit for physicians. These findings serve as a reminder to policymakers that unanticipated behavioral responses can undermine their ability to achieve savings simply through fee reductions.

Assessment

I hope you enjoy reading the essay and others on the NIHCM website.

http://www.nihcm.org/pdf/EV-JacobsonNewhouseFINAL.pdf

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Essay on Medicare Pricing Distortions

Posted on September 17, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

In Physician Fee Schedules

By Nancy Chockley PhD
President & CEO
NIHCM Foundation

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Leaving Medicare F-F-S Reimbursement

While there is near universal agreement that we need to move away from Medicare’s fee-for-service [F-F-S] physician payment system, Dr. Robert Berenson argues that in the short term we still need to focus on improving the current physician fee schedule.

Reasons Why?

Not only are the value-based payment systems that most reformers envision still many years from widespread reality, the existing fee schedule prices will serve as the building blocks for some of the newer aggregate payment approaches.

Assessment

In his Expert Voices essay, Dr. Berenson offers thoughts on how to improve the system in ways that both address current payment system woes and serve as a step toward future value-based payment systems.

Link: http://nihcm.org/pdf/NIHCM-EV-Berenson_FINAL.pdf

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email: nihcm@nihcm.org
website: www.nihcm.org

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Taxing Sin to Modify Behavior and Raise Revenue‏

Posted on April 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

NIHCM Expert Voices

By Nancy Chockley PhD [President & CEO]
[NIHCM Foundation]

Sin taxes on tobacco and alcohol have a long history in the U.S., and many credit cigarette taxes as being the single most effective strategy in achieving our dramatic reductions in smoking.  Similar taxes have been proposed in recent years as one weapon in our fight against rising obesity rates, and a new study has just added support for this policy by showing that higher prices for sweetened sodas are associated with lower caloric intake, lower weight, and better health.

Rationale Reviews

In his essay, Dr. Jonathan Gruber reviews the rationales for and experience with sin taxes for cigarettes and alcoholic beverages, and offers his insights on using sin taxes to combat obesity.

http://www.nihcm.org/pdf/ExpertVoices_Gruber_April2010.pdf

Related Others

Other recent “Expert Voices” essays on health reform include:

Assessment

I hope you enjoy reading these essays and those that follow, down-line.

Phone: 202-296-4426
email: nihcm@nihcm.org
Website: www.nihcm.org

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Why America Spends More on Healthcare

Posted on October 23, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A McKinsey Global Institute Review

By Nancy Chockley; PhD
President & CEO
NIHCM FoundationRed Cross

Path breaking work by the McKinsey Global Institute (MGI) shows that, relative to other peer countries from the Organization for Economic Cooperation and Development, the U.S. spends nearly $650 billion more on health care than would be expected after adjusting for cross-country differences in wealth.  Fully two-thirds of this added spending occurs in the outpatient sector. 

Out-Patient Services

The highly profitable nature of many outpatient services coupled with the incentives of a fee-for-service payment system are contributing to greater intensity of outpatient care and helping to fuel this spending.  In this essay, “Why America Spends More on Health Care,” Eric Jensen and Lenny Mendonca describe MGI’s work to examine all sectors of the American health care system and identify factors responsible for the higher-than-expected spending.  

More Examples

Other recent Expert Voices essays on health reform include:

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