Health Care Policy and Reform

Pharmacy Benefits and the Use of Drugs by the Chronically Ill

Published: | 8:59 pm | Posted in: Health Care Policy and Reform

The use of medications such as antihistamines and NSAIDs, which are taken intermittently to treat symptoms, was sensitive to co-payment changes. Other medications—antihypertensive, antiasthmatic, antidepressant, antihyperlipidemic, antiulcerant, and antidiabetic agents—also demonstrated significant price responsiveness. The reduction in use of medications for individuals in ongoing care was more modest. Still, significant increases in co-payments raise concern […]

Will Fewer Children Boost Demand for Formal Caregiving?

Published: | 7:28 pm | Posted in: Health Care Policy and Reform

Today, 25 percent of all caregivers of elderly are adult children.  However, while the parents of the Baby Boom generation had three children per household on average, the Boomers themselves only have two.  This project uses the Health and Retirement Study to assess how the number of children a person has affects the demand for formal long-term […]

Competition in Health Insurance: A comprehensive study of U.S. markets

Published: | 3:04 pm | Posted in: Health Care Policy and Reform

This is the 17th edition of the American Medical Association’s “Competition in health insurance: A comprehensive study of U.S. markets.” This report presents new data on the degree of competition in health insurance markets across the country, It is intended to help researchers, policymakers, and federal and state regulators identify markets where consolidation among health […]

The Price of Health Care: Why Is the United States an Outlier?

Published: | 8:07 pm | Posted in: Health Care Policy and Reform

Higher prices are increasingly recognized as a significant cause of the outlier status of the United States in health care expenditures. At the same time, various explanations are often invoked to justify higher prices as rational or even defensible. We evaluate—and mostly counter—potential explanations of why health care prices are higher in the United States: […]

Health Care Cost Control: Where Do We Go From Here?

Published: | 5:58 pm | Posted in: Health Care Policy and Reform

Medical services are expensive. There is no getting around it. The average family health insurance premium in the US is approaching $20,000. By one estimate, average family premiums could rise to 100 percent of US median household income by 2033 if trends continue. What is more troubling is that there is considerable evidence that nearly one-third of health spending is […]

After Defeat: Conservative Postenactment Opposition to the ACA in Historical-Institutional Perspective

Published: | 7:00 pm | Posted in: Health Care Policy and Reform

Since the enactment of the Affordable Care Act (ACA) in 2010, conservatives have sought to undermine the law’s entrenchment. While they have failed in their ambitious quest to repeal the ACA, opponents have succeeded in overturning one major provision (the individual mandate penalty), narrowing the law’s reach, complicating its implementation, and fomenting doubts about its […]

Health Care Spending in the United States and Other High-Income Countries

Published: | 6:11 pm | Posted in: Health Care Policy and Reform

Key Points Question  Why is health care spending in the United States so much greater than in other high-income countries? Findings  In 2016, the United States spent nearly twice as much as 10 high-income countries on medical care and performed less well on many population health outcomes. Contrary to some explanations for high spending, social spending and […]

The Ryan Budget and Medicare – Headed The Wrong Way

Published: | 8:00 pm | Posted in: Health Care Policy and Reform

As today’s older Americans look forward to retirement, they worry about whether Medicare will meet their needs – indeed, whether it will even be there. Both worries are justified. Medicare has been a godsend to senior citizens, but its protections are eroding and need to be improved. Unfortunately, many politicians in Washington want to place […]

National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment

Published: | 10:08 pm | Posted in: Health Care Policy and Reform

Health spending growth in the United States for 2015–25 is projected to average 5.8 percent—1.3 percentage points faster than growth in the gross domestic product—and to represent 20.1 percent of the total economy by 2025. As the initial impacts associated with the Affordable Care Act’s coverage expansions fade, growth in health spending is expected to be influenced by […]

Early Performance of Accountable Care Organizations in Medicare

Published: | 8:33 pm | Posted in: Health Care Policy and Reform

BACKGROUND In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. We used quasi-experimental methods to assess the early performance of MSSP ACOs. METHODS Using Medicare claims from 2009 through 2013 and a difference-in-differences design, we compared changes in spending and in performance on quality […]

Health Spending Growth: Still Facing A Triangle Of Painful Choices

Published: | 1:21 am | Posted in: Health Care Policy and Reform, Neoliberalism

In the four years immediately following the recession (2010 through 2013), health spending grew at a historically low average annual rate of 3.6 percent, about the same as gross domestic product (GDP). This era was interrupted in 2014 with the advent of expanded coverage under the Affordable Care Act (ACA)—the newly insured used more care […]

Health Affairs Study On Hospital Profitability Gives Us Some Important Factors To Watch Going Forward

Published: | 12:57 am | Posted in: Health Care Policy and Reform

It is important to keep in mind that profits can be high, either because prices are high or underlying production costs are low (relative to each other). The Bai and Anderson study does not decompose profits but rather measures overall accounting profits as reported to Medicare. So, higher profits do not always indicate excess prices. […]

The U.S. Health Disadvantage And The Role Of Spending

Published: | 12:56 am | Posted in: Health Care Policy and Reform

Each week it seems, more evidence emerges regarding the poor health of Americans. We first documented a “U.S. health disadvantage” as chair and study director of the panel on understanding cross-national health differences among high-income countries at the National Academies in 2013. Our panel’s report Shorter Lives, Poorer Health showed that, as long ago as […]

The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act A Data Snapshot

Published: | 6:07 pm | Posted in: Health Care Policy and Reform, Medicare

Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating limitations to access. Choice […]

The Value of Medicaid

Published: | 7:58 pm | Posted in: Health Care Policy and Reform, Medicaid

Medicaid is the largest means-tested program in the U.S., with expenditures of over $425 billion in 2011. The Oregon Health Insurance Experiment, a recent expansion of the Medicaid program in that state that occurred by random assignment, has provided some of the most compelling evidence to date on the program’s effects. A series of previous […]

The Oregon Health Insurance Experiment: Evidence from the First Year*

Published: | 7:31 pm | Posted in: Health Care Policy and Reform

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled […]