The Outlook for Spending on Health Care and Long-Term Care - - PowerPoint PPT Presentation
Congressional Budget Office Presentation to the National Governors Association's Health and Human Services Committee The Outlook for Spending on Health Care and Long-Term Care February 24, 2008 Federal Spending Under CBOs Alternative
Percentage of GDP
1962 1972 1982 1992 2002 2012 2022 2032 2042 2052 2062 2072 2082 10 20 30 40 Medicare and Medicaid Actual Projected Social Security Other Spending (Excluding debt service)
Percentage of GDP
2007 2012 2017 2022 2027 2032 2037 2042 2047 2052 2057 2062 2067 2072 2077 2082 5 10 15 20 Effect of Excess Cost Growth Effect of the Aging of the Population
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
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.
Source: Elliot Fisher, Dartmouth Medical School.
Care Delivery―and Spending―Among Medicare Patients in Last Six Months of Life 1.1 1.0 2.9 Ratio, medical specialist / primary care 23.9 42.2 52.1 Physician visits 12.9 17.7 19.2 Hospital days 26,330 40,181 50,522 Total Medicare spending 90.4 85.9 81.5 CMS composite quality score Biologically Targeted Interventions: Acute Inpatient Care Mayo Clinic (St. Mary’s Hospital) Massachusetts General Hospital UCLA Medical Center
Use of Biologically Targeted Interventions and Care-Delivery Methods Among Three of U.S. News and World Report’s “Honor Roll” AMCs
Source: Elliot Fisher, Dartmouth Medical School.
Source: CBO calculations using data from Thomson Healthcare and the Medicaid Statistical Information System.
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 10 20 30 40 50
Personal Care Home and Community-Based Services Waiver Home Health Skilled Nursing Facilities Intermediate Care Facilities for the Mentally Retarded
Billions of Dollars
Source: Thomson Healthcare analysis using CMS 64 data. Note: Data include federal and state spending.
Not Including Informal Care Including Informal Care
Sources: CBO; CMS Office of the Actuary; and Arno, P., and others, "The Economic Value of Informal Caregiving," Health Affairs, vol. 18, no. 2 (2002). Medicaid (45%) Medicare (23%) Private Insurance (8%) Out-of-Pocket Payments (19%) Other (5%) Medicaid (19%) Medicare (10%) Private Insurance (3%) Out-of-Pocket Payments (8%) Other (2%) Informal Care (58%)
1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 100 200 300 400 500 600 700 800
Thousands
Sources: CBO (based on conversations with industry experts) and data from AHIP.
Source: HRS/AHEAD.
Thousands of Dollars
Total Population Impaired Populationa 50 100 150 200 250 199.4 84.8 84.5 31.0 Total Assets Net Nonhousing Assets
2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 5 10 15 20 25
Age 65 and Older Age 85 and Older
Percentage of Total Population
Source: U.S. Bureau of the Census.
Source: Data from Singh and Siahpush (2006) and CDC. At Birth At Age 65 1 2 3 4
Increase in Average Life Expectancy, 1980–2000 Increase in Difference in Average Life Expectancy Between Lowest and Highest Decile, 1980–2000
Years