SLIDE 1
Spending on Medicare and Medicaid and on Social Security as a Percentage of GDP, 2007 and 2017
20 07 2 01 7 1 2 3 4 5 6 7 3.2 1.4 4.6 4 .2 4 .2 4.0 1.9 5.9 4 .8 4 .8
Me dicaid Me dicare Social Se curity
Institute of Medicines 2007 Annual Meeting Peter R. Orszag - - PowerPoint PPT Presentation
Institute of Medicines 2007 Annual Meeting Peter R. Orszag - - PowerPoint PPT Presentation
Congressional Budget Office Presentation for the Institute of Medicines 2007 Annual Meeting Peter R. Orszag Director October 8, 2007 Spending on Medicare and Medicaid and on Social Security as a Percentage of GDP, 2007 and 2017 7 Me
SLIDE 2
SLIDE 3
Total Federal Spending for Medicare and Medicaid Under Assumptions About the Health Cost Growth Differential
Percent of GDP
1966 1972 1978 1984 1990 1996 2002 2008 2014 2020 2026 2032 2038 2044 2050 5 10 15 20 25
Actual Projection 2.5 Percentage Points 1 Percentage Point Zero Differential of:
SLIDE 4
Effects of Slowing the Growth of Spending for Medicare and Medicaid
Percent of Gross Domestic Product
1966 1972 1978 1984 1990 1996 2002 2008 2014 2020 2026 2032 2038 2044 2050 5 10 15 20 25
Actual Projection 2.5 Percentage Points Differential of: 1 Percentage Point Beginning in 2025 1 Percentage Point Beginning in 2015
SLIDE 5
Medicare Spending per Capita in the United States, by Hospital Referral Region, 2003
Source: www.dartmouthatlas.org.
$7,200 to 11,600 (74) 6,800 to < 7,200 (45) 6,300 to < 6,800 (55) 5,800 to < 6,300 (60) 4,500 to < 5,800 (72) Not Populated
SLIDE 6
The Relationship Between Quality and Medicare Spending, by State, 2004
73 78 83 88 4,000 5,000 6,000 7,000 8,000
Spending (Dollars)
Composite Measure of Quality of Care Source: Data from AHRQ and CMS.
SLIDE 7
Share of Personal Health Care Expenditures Paid Out of Pocket
1975 1985 1995 2005 2015 5 10 15 20 25 30 35
33% 26% 17% 15% 13%
Percent
SLIDE 8
Effects of Cost Sharing
Source: Based on data from RAND’s health insurance experiment. Dollars per Enrollee
Free- Care Plan Conventional Plan ($400 deductible, 25% coinsurance, $4,000 limit) High- Deductible Plan ($4,000 deductible and limit) 500 1,000 1,500 2,000 2,500 3,000 3,500
3,440 26% 2,228 15% 2,116
SLIDE 9
Costs and Impact of Comparative Effectiveness Research Depend on Type of Research
§ Systematic Reviews § Modeling § Analyses of Claims Data § Registries § Practical Clinical Trials § Randomized Controlled Trials
SLIDE 10
Other Factors Affecting Budgetary Impact
§ In the Short Term, Several Constraints
– Time Needed to Generate New Findings, Reach Consensus – Time Needed to Incorporate Findings into Incentives – Changes to Medicare Required to Permit Full Adoption
§ In the Long Term, Savings Seem Likely
– Currently, Providers Usually Have Incentives to Adopt New Technology, Enrollees Have Little “Skin in the Game,” and Payers Have Limited Information – Expanding the Evidence Base Thus Seems More Likely to Limit Future Spending Increases than to Fuel Them
SLIDE 11
Key Questions § Which Approach to Research is Most Cost-Effective? – More Evidence on Returns? § Relative Power of Information and Incentives? – Consumer-Directed or Value-Based Insurance? § Compare Clinical Effectiveness or Cost-Effectiveness
- f Treatments?