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    2009 Medicare Related Studies and Reports

     If folks are going to be throwing around data . . .

    Then I have listed the following sources that are available through the Kaiser Foundation that I and my family have been associated with going on 28 years.


    Topics > Health Systems > Issue Modules > U.S. Health Care Costs

    U.S. Health Care Costs Issue Module
    Background Brief Key Data Policy Research Webcasts/Presentations Key Organizations

    Policy Research

    Overview
    Cost Containment
    Health Care Cost Drivers
    Impact on Individuals
    Medicaid and Medicare
    ---------------------------

    Overview

    Axeen, S. and E. Carpenter. November 2008. The Cost of Doing Nothing: Why the Cost of Failing to Fix Our Health System is Greater than the Cost of Reform. New America Foundation.
    This report quantifies the economic cost of failure to enact health reform in America versus the expected costs of such reform.

    Congress of the United States, Congressional Budget Office. July 2007. Financing Projected Spending in the Long Run. 
    This report analyzes the potential economic effects of increasing taxes to finance the expected increase in health spending over the next several decades.

    Congress of the United States, Congressional Budget Office. January 2008. Geographic Variation in Health Care Spending.
    This report examines the amount of geographic variation in spending, the reasons for that variation, and its implications for evaluating the efficiency of the health care system.

    Congress of the United States, Congressional Budget Office. December 2008. Budget Options: Volume 1: Health Care.
    This publication presents budget options related to health care, including financing, delivery and access, within federal programs and the general health system.

    Cutler, D. M., A. B. Rosen, and S. Vijan.  August 2006. The Value of Medical Spending in the United States, 1960-2000.  New England Journal of Medicine, 355: 920-927.
    This article examines the value of increased medical spending by comparing gains in life expectancy with the increased costs of care.

    Executive Office of the President Council of Economic Advisers. June 2009. The Economic Case for Health Care Reform.
    This report provides a comprehensive analysis of the economic impacts of health reform.

    Farrell, D. et al. December 2008. Accounting for the cost of U.S. health care: A new look at why Americans spend more. McKinsey Global Institute.
    The United States spends a greater percentage of its GDP on health care than any other industrialized country.  This study takes a holistic view of the health care system to identify the explanations for higher U.S. health care spending.

    Henry J. Kaiser Family Foundation. July 2008. Tax Subsidies for Health Insurance: An Issue Brief.
    This issue brief examines the current system of tax subsidies for the purchase of employer-sponsored coverage
    .

    Holahan, J., Bowen, G., Headen, I., and Lucas, A.  May 2009. Health Reform: The Cost of Failure. The Urban Institute.
    Using
    the Health Insurance Policy Simulation Model, this paper analyzes the intermediate and long-run implications if America's health system is not significantly overhauled.

    Nuzum, R., S. Mika, C. Schoen, and K. Davis. June 2009. Finding Resources for Health Reform and Bending the Health Care Cost Curve. The Commonwealth Fund.
    This report examines policy options that could slow growth in health spending, improve health outcomes, and provide additional revenues to finance comprehensive reform.

    Posner, P., T. Mitchell, and J. Forrester. February 2005. 21st Century Challenges: Reexamining the Base of the Federal GovernmentGovernment Accountability Office GAO-05-325SP. 
    This report is intended to help Congress in reviewing and reconsidering the base of federal spending and tax programs, including a chapter that focuses on Health Care Challenges.

    Thorpe, K. E.  November/December 2005. The Rise in Health Care Spending and What To Do About It.  Health Affairs, 24(6): 1436-1445.
    This article examines causes for the growth of health spending, such as obesity and stress, over the past twenty years and suggests reform options.

    White, C.  January/February 2007. Health Care Spending Growth: How Different Is the United States From the Rest of the OECD?  Health Affairs, 26(1): 154-161.
    This paper compares factors contributing to health care spending growth in the United States to that of other OECD countries.


    Cost Containment

    Altman, D. and L. Levitt. January 2002. The Sad History of Health Care Cost Containment As Told In One Chart.  Health Affairs Web Exclusive.
    This commentary attempts to explain the factors affecting rising health care costs and how past solutions to solve the expense problem have fared.

    Altman, S. and S. Wallack. 1996. Health Care Spending: Can the United States Control it?  Baxter Health Policy Review 2:1-32.
    This chapter begins with an examination of the problems facing health care, outlines recent trends in health care spending, details reasons why spending is rising so rapidly, and reviews health care reform proposals.

    Anderson, G. F., B. K. Frogner, R. A. Johns, et. al.  May/June 2006. Health Care Spending and Use of Information Technology in OECD Countries. Health Affairs, 25(3): 819-831.
    This paper analyzes the differences in uses of health information technology (HIT) in the United States and other OECD countries and proposes a greater adoption of HIT to lower health care expenditures in the United States.

    Buntin, M. B., C. Damberg, A. Haviland, et. al.  November/December 2006. Consumer-Directed Health Care: Early Evidence About Effects on Cost and Quality.Health Affairs Web Exclusive.
    This report examines the advent of consumer-directed health care plans and their impact on health care costs.

    Chernew, M.E., P.D. Jacobson, T.P. Hofer, et al. November/December 2004. Barriers to Constraining Health Care Cost Growth. Health Affairs 23(6):122-128.
    These authors conducted several semistructured interviews and present their discussion of how to slow the growth of health care expenditures, looking specifically at managed care as a method of cost containment.

    Davis, K., C. Schoen, S. Guterman, et. al.  January 2007. Slowing the Growth of U.S. Health Care Expenditures: Where Are the Options? The Commonwealth Fund.
    This report reviews factors that contribute to high spending on the health care system in the United States and analyzes strategies for accumulating savings, reducing spending growth, and improving health system performance.

    Fireman, B., J. Barlett, and J. Selby. November/December 2004. Can Disease Management Reduce Health Care Costs by Improving Quality? Health Affairs, 23(6):63-75.
    This papers examines disease management programs (DPMs) in a Kaiser Permanente Medical Group setting.

    Ginsburg, P. B. March/April 2007. Shopping for Price in Medical Care. Health Affairs Web Exclusive.
    This report analyzes the way in which individuals select health care services based on price and the influence that insurers and the government can have on price selection.

    Hoffman, A. and S. Pearson. June 2009. Marginal Medicine: Targeting Comparative Effectiveness Research to Reduce Waste. Health Affairs Web Exclusive.
    This paper provides a framework for leveraging comparative effectiveness research to maximally improve health care services.

    Newhouse, J. November/December 2004. Consumer-Directed Health Plans and the RAND Health Insurance Experiment. Health Affairs 23(6):107-113.
    The author compares today's consumer-directed health plans to the RAND Health Insurance Experiment of the 1970s and 1980s. He suggests policy reforms to address the continual rise in health care costs, including a combination of managed care and cost sharing.

    Rosenthal, M.B. May 2009. What Works in Market-Oriented Health Policy? New England Journal of Medicine 360;21.
    This perspective piece discusses how best to design and implement market-oriented reforms to improve the medical system.

    Watson Wyatt. March 2009. The 14th Annual National Business Group on Health/Watson Wyatt Employer Survey on Purchasing Value in Health Care-- The Keys to Continued Success: Lessons Learned From Consistent Performers
    This survey of employers presents a profile of trends in employer sponsored insurance, including large disparities between cost trends of best- and worst-performing companies and growing interest in consumer-directed health plans.

    Zuvekas, S. H. and J. W. Cohen. January/February 2007. Prescription Drugs and the Changing Concentration of Health Care Expenditures. Health Affairs 26(1): 249-257.
    This paper explores the concentration of health care spending in various sectors and possible implications for cost containment.


    Health Care Cost Drivers

    Bieder, P. January 2004. Limiting Tort Liability for Medical MalpracticeCongressional Budget Office Economic & Budget Issue Brief.
    This brief examines state activities related to reducing malpractice litigation and some possible causes for the rise in malpractice premiums. Although malpractice premiums continue to escalate at about 15 percent a year, the Congressional Budget Office notes that significant reductions in this rate of growth would only modestly affect overall health spending growth.

    Bodenheimer, T. 2005. High and Rising Health Care Costs.  Annals of Internal Medicine.
    In this series, the author examines possible factors contributing to the rise in national health expenditures and cost-containment strategies that emphasize quality improvement as well as lowering spending.
    Part One looks at different explanations for rising health care costs; 
    Part Two looks specifically at technology as a major factor in expenditures; 
    Part Three looks at how prices and quantities of health care services affect spending; and 
    Part Four, written with Dr. Alicia Fernandez, looks at quality-enhancing strategies that might help slow the growth of health care costs.

    Congress of the United States, Congressional Budget Office. January 2008. Technological Change and the Growth of Health Care Spending.
    This CBO paper describes the historical growth in spending on health care in the U.S. It examines the factors that determine health care spending and how they have contributed to spending growth over time.

    Henry J. Kaiser Family Foundation. March 2007. Snapshots: Health Care Costs. How Changes in Medical Technology Affect Health Care Costs.
    This report describes medical technology and the mechanisms by which it affects the growth in health care costs.

    Fisher, E., D. Goodman, J. Skinner, and K. Bronner. February 2009. Health Care Spending, Quality, and Outcomes: More Isn't Always Better.  Dartmouth Atlas Project Topic Brief.
    This topic brief examines the relationship between regional differences in spending and the quality of care, and implications of this relationship for U.S. health reform.

    Keenan, P. S. November 2004. What's Driving Health Care Costs? The Commonwealth Fund
    This paper discusses the causes of rising health care costs and analyzes the results of the increased spending.

    Moeller, J., G. Miller, and J. Banthin. September/October 2004. Looking Inside the Nation's Medicine Cabinet: Trends in Outpatient Drug Spending by Medicare Beneficiaries, 1997 and 2001. Health Affairs 23(5):217-225. 
    The authors examine trends in outpatient prescription drug spending by the Medicare civilian, noninstitutionalized population in 1997 and 2001 using nationally representative data from the Medical Expenditure Panel Survey.

    Mullins, C.D., A.R. DeVries, V.D. Hsu, et al. July/August 2005. Variability and Growth in Spending for Outpatient Specialty Pharmaceuticals. Health Affairs 24(4):1117-1127.
    This study of ten Blue Cross Blue Shield plans documents large expenditures on select specialty pharmaceutical categories and much variation in spending across plans, age groups, and time.

    Pauly, M. V. November/December 2005. Competition and New TechnologyHealth Affairs, 24(6): 1523-1535.
    This paper discusses the effect of new technologies on health care prices and ways in which adopting different policies toward technology could increase competitiveness between insurers.

    Reinhardt, U. November/December 2003. Does the Aging of the Population Really Drive the Demand for Health Care? Health Affairs 22(6):27-39.
    This essay draws on the research literature and on data from the Medical Expenditure Panel Surveys to explore the impact that the aging of the US population has on the annual growth in the demand for health care and in national health spending.

    Thorpe, K., C. Florence, and P. Joski. August 2004. Which Medical Conditions Account for the Rise in Health Care Spending? Health Affairs Web Exclusive.
    This research looks at the level and growth in health care spending attributable to the fifteen most expensive medical conditions in 1987 and 2000. The authors found that a small number of conditions account for most of the growth in health care spending.


    Impact on Individuals

    Collins, S. R., J. Kriss, and K. Davis.  September 2006. Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families. The Commonwealth Fund.
    This study compares adults with employer-based coverage and adults in the individual insurance market on a variety of factors including out-of-pocket payments, deductible rates, and percentage of income spent on health care.

    Doty, M., J. Edwards, and A. Holmgren. August 2005. Seeing Red: Americans Driven into Debt by Medical BillsThe Commonwealth Fund
    This issue brief analyzes data from the 2003 Commonwealth Fund Biennial Health Insurance Survey to examine trends in health care spending, medical debt, and the uninsured.

    Henry J. Kaiser Family Foundation. February 2007. Snapshots: Health Care Costs. Insurance Premium Cost-Sharing and Coverage Take-Up.
    This issue brief looks at the connection between premiums and the percent of workers who enroll in employer plans.

    Henry J. Kaiser Family Foundation. July 2009. Data Note: Footing the Bill.
    This brief data note synthesizes several recent polls on the public's willingness to pay for expansion of health coverage to their fellow citizens.

    Remler, D. K. and S. A. Glied. July/August 2006. How Much More Cost Sharing Will Health Savings Accounts Bring? Health Affairs, 25(4): 1070-1078.
    This paper examines the impact of health savings accounts on out-of-pocket medical expenditures.

    Weinick, R., S. Byron, and A. Bierman. June 2005. Who Can't Pay for Health Care? Journal of General Internal Medicine 20(6):504-509. 
    This cross-sectional study uses data from the Commonwealth Fund 2001 Health Care Quality Survey to examine barriers to health care.


    Medicaid and Medicare

    Congress of the United States Congressional Budget Office. November 2007. The Long-Term Outlook for Health Care Spending.
    This study presents the Congressional Budget Office's projections of federal spending on Medicaid and Medicare, as well as national spending on health care, over the next 75 years.

    Centers for Medicare and Medicaid Services. May 2009. Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.
    The annual report by the Board of Trustees for Medicare to the Congress contains information on the past and estimated future financial operations of the Hospital Insurance and Supplementary Medical Insurance Trust Funds.

    Coughlin, T., T. Waidmann, and M. O. Watts. April 2009. Where Does the Burden Lie?: Medicaid and Medicare Spending for Dual Eligible Beneficiaries. Kaiser Commission on Medicaid and the Uninsured; Henry J. Kaiser Family Foundation.
    This issue brief examines Medicare and Medicaid spending on "dual eligibles," those who are simultaneously enrolled in both programs.

    Garrett, B. et al. May 2009. The Coverage and Cost Impacts of Expanding Medicaid. Kaiser Commission on Medicaid and the Uninsured; Henry J. Kaiser Family Foundation.
    This paper quantifies the impacts on coverage and cost of expanding Medicaid to cover more of the low-income uninsured, including adults, at various income levels and with improved participation rates.

    Jaffe, J. and P. Fronstin. February 2005. Controlling Health Costs and Improving Health Care Quality for Retirees.Employee Benefit Research InstituteIssue Brief No. 278.
    This brief looks at the issue of rising health care costs, especially for Medicare enrollees and other retirees and gives some policy reform suggestions.

    Henry J. Kaiser Family Foundation. June 2007. Medicare Spending and Financing Fact Sheet.  
    This fact sheet provides an overview of spending on the Medicare program, how the program is financed, and Medicare's future financial outlook.

    Kaiser Commission on Medicaid and the Uninsured. May 2006. Medicaid Enrollment and Spending TrendsThe Henry J. Kaiser Family Foundation.
    This fact sheet summarizes enrollment growth, changes in health insurance coverage, and spending growth for Medicaid from 2000 to 2004.

    Kronick, R. and D. Rousseau.  March/April 2007. Is Medicaid Sustainable? Spending Projections for the Program's Second Forty Years. Health Affairs 26(2): 271-287.
    This article examines the long-term fiscal sustainability of the Medicaid program.

    MedPAC. June 2007. Report to the Congress: Promoting Greater Efficiency in Medicare.
    This report examines the issues affecting Medicare and makes specific recommendations to Congress.

    Poisal, J. A., C. Truffer, S. Smith, et. al. March/April 2007. Health Spending Projections Through 2016: Modest Changes Obscure Part D's ImpactHealth AffairsWeb Exclusive.
    This article analyzes the projected increase in health care spending through 2016 and the specific impact of the Medicare prescription drug program.

    Riley, G. May/June 2007. Long-Term Trends in the Concentration of Medicare SpendingHealth Affairs, 26(3): 808-816.
    This paper analyzes the concentration of spending and cost containment efforts within the population of Medicare enrollees over the past thirty years.




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