The future of US health spending: what is possible while improving the health

The future of US health spending: what is possible while improving the health -

The future of US health spending: what is possible while improving health

[? June 26, 2014 Emily Newhook

as the US economy continues to recover of the recession, the growth of health care spending remains at historically low rates. Recently, the Brookings Institution brought together economic and political health experts to discuss whether this slowdown will persist in the future. The last panel of the conference was "Improving health while reducing cost growth: what is possible"

The panel

Alice Rivlin is the Leonard D. Schaeffer chair in health policy studies, director of the Engelberg Center for healthcare reform and principal investigator in the economic studies program at Brookings. as an expert on fiscal policy and monetary Rivlin was founding director of the Congressional Budget Office (CBO) and recently served on the Commission debt of the President.

Mark McClellan is senior fellow and director of innovation health care and Value Initiative at the Brookings Institution. McClellan instituted important health policy reforms that the former Commissioner of the US Food and Drug Administration, including Medicare drug benefit. He is a physician and economist whose centers on promoting the quality and value in health care focused on patient work.

Joseph Antos is the Wilson H. Taylor scholar in health care and retirement policy at the American Enterprise Institute. His research is mainly related to the economics of health policy, including the Affordable Care Act, Medicare, reform of the health care system and uninsured overall. Previously, he served as deputy director of health and human resources to the CBO.

David Cutler is Professor Otto Echstein of Applied Economics at Harvard University. His health and public economics economy on research work was presented in journals and the popular press. Cutler served as senior advisor in health care for the Obama presidential campaign and was on the Council of Economic Advisers and the National Economic Council in the Clinton administration.

The panel was moderated by Ted Gayer , the Vice-President and Chief Economist, and Joseph A. Pechman, senior fellow at the Brookings Institution. Its economic issues on research focuses on public finance, environmental economics and energy, housing and regulatory policy.

Key Insights

The discussion highlighted the most integrated issues to maintain a reasonable rate of growth in health care spending the future. Three types of political reform have been described:

payment provider Models

• All discussions payment reforms have stressed the need to move further compensation models services that focus on the volume and intensity of services and move towards models focused on patients who rely on the quality and / or patient outcomes.
• McClellan discussed the capitation model, which involves the health care delivery system assuming the full financial risk for all services, by fully integrating health insurance within the distribution system and fixed repayment layout to consumers. In this scenario, McClellan said: "Any measure that suppliers can take over their delivery system to reduce costs resulted in net income; it promotes cost reduction. "Kaiser is an example of a full capitation system.
• McClellan noted many systems are too small and fragmented to employ full capitation, but have set up secondary payment systems alongside service payment systems that allow gradual changes to payment models centered on the patient in the future

McClellan :. prevention alone can not lower the costs, just delay until that patients have other health problems later in life #healthspending

-. MHA @ GW (@GWonlineMHA) April 11, 2014

consumer choice and market competition

• Rivlin pointed insurance drawings based on the value as a mechanism "interesting and promising" to introduce more competition and consumer choice informed in the health care system. In this design, copays are lower for high-value treatments, potentially improve health and save money at the same time.
• Rivlin cited Pitney Bowes company's insurance plan as an example, saying: "[The company] reduced copays for long-acting medications against asthma and got a discount 22 percent in the use of ER by asthma patients and a reduction of 62 percent of avoidable hospitalizations. Here's a small population, but a fairly dramatic illustration that this kind of design can make a difference. "
• Allow plans compete on regulated markets is another reform that can promote market competition. Transparency on premiums and information on patient outcomes is necessary to allow consumers to choose plans to best meet their needs.

Prevention and Wellness

• Although the behavior and environmental changes outside the health care system have been noted to help improve the quality of life, McClellan said: "prevention is very useful, but can simply deliver health care to spend a little. that helps us in the short term ... but that does not necessarily mean a clear impact on the cost of health care. "in other words, people can live longer and healthier, but still be susceptible to health risks in the elderly that will result in health care spending.
• conversely, the obesity prevention was noted as a health problem that could have a significant impact on health expenditure due to the impact of obesity on chronic diseases costly that could manage for a long period of time.

Panelist Antos noted that the most important issue at hand is "the improvement of health ... it is not the improvement of the health system." Professionals public health such as @ GW graduates MHA can help ensure the health of the public is at forefront of any conversation about reforming the health system and the health care spending by working with policy makers, providers health care and consumers in the future.