Exhibit 1. National Health Expenditures per Capita, 1980–2007

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Presentation transcript:

Exhibit 1. National Health Expenditures per Capita, 1980–2007 Data: OECD Health Data 2009 (June 2009).

Exhibit 2. National Health Expenditures as a Percentage of Gross Domestic Product, 1960–2020 Projected Data: Centers for Medicare and Medicaid Services, The Lewin Group.

Exhibit 3. Average Family Premium as a Percentage of Median Family Income, 1999–2020 Projected Data: Commonwealth Fund calculations based on Kaiser/HRET, 1999-2008; 2008 MEPS-IC; U.S. Census Bureau, Current Population Survey; Congressional Budget Office.

Exhibit 4. Total Number of Uninsured, 1963–2010 Millions uninsured Note: Figures for 1963-1974 are U.S. residents without hospital insurance. Data: National Health Interview Survey, Current Population Survey, The Lewin Group.

Exhibit 5. National Health Expenditures (NHE) Under Alternative Scenarios, U.S. Constant 2010 Dollars, 1960–2010 NHE in billions 5.2% annual growth $2,624 4.8% annual growth $2,110 $1,702 $1,583 4.3% annual growth 4.2% annual growth Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 6. National Health Expenditures (NHE) Under Alternative Scenarios, U.S. Constant 2010 Dollars, 1960–2010 NHE in billions 5.2% annual growth $2,624 $2,270 4.9% annual growth $1,967 $1,875 4.6% annual growth 4.5% annual growth Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 7. National Health Expenditures (NHE) Under Alternative Scenarios, Percentage of Gross Domestic Product, 1960–2010 NHE (% GDP) 17.7% 14.2% 11.5% 10.7% 9.0% 3.8% Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 8. National Health Expenditures (NHE) Under Alternative Scenarios, Percentage of Gross Domestic Product, 1960–2010 NHE (% GDP) 17.7% 15.3% 13.3% 12.7% 9.0% 3.8% Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 9. Federal Health Expenditures (FHE) Under Alternative Scenarios, Percentage of Gross Domestic Product, 1960–2010 FHE (% GDP) 6.2% 5.0% 4.0% 3.7% Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 10. Federal Health Expenditures (FHE) Under Alternative Scenarios, Percentage of Gross Domestic Product, 1960–2010 FHE (%GDP) 6.2% 5.3% 4.6% 4.4% Data: The Centers for Medicare and Medicaid Services; Bureau of Labor Statistics, Office of Management and Budget, Congressional Budget Office.

Exhibit 11. System Improvement Provisions of National Health Reform Proposals, 2009 House of Representatives 11/05/09 Senate 11/18/09 Exchange Standards and Plans National or state exchanges; private, public, or co-op plans offered; essential health benefits 70%–95% actuarial value, four tiers; insurers must meet specified medical loss ratio of 85 percent State or regional exchanges; private and co-op plans offered; public plan with state opt-out; essential health benefits 60%–90% actuarial value, four tiers plus young adults policy; insurers must report medical loss ratio Innovative Payment Pilots: Medical Homes, Accountable Care Organizations, Bundled Hospital and Post-Acute Care Adopt medical homes, ACOs, and bundled payments on large scale if pilot programs prove successful; Center for Payment Innovation Allow Medicaid beneficiaries to designate medical home; ACOs to share savings in Medicare; CMS Innovations Center Productivity Improvements Modify market-basket updates to account for productivity improvements Modify market-basket updates to account for productivity improvements Primary Care Increase Medicare payments for PCPs by 5%; bring Medicaid PCPs up to Medicare level 10% bonus payments for 5 years; half of the costs offset by across-the-board reduction in all other services Prevention and Wellness Develop a national prevention and wellness strategy; establish a Prevention and Wellness Trust Fund; remove cost-sharing for proven preventive services; grants to support employer wellness programs Provide annual wellness visit and/or health risk assessment for Medicare beneficiaries; strengthen state and employer wellness programs; remove cost-sharing for proven preventive services Comparative Effectiveness Establish Center for Comparative Effectiveness Research within AHRQ Create Patient-Centered Outcomes Research Institute Quality Improvement Establish the Center for Quality Improvement to identify, develop, evaluate, disseminate, and implement best practices; develop national priorities for performance improvement and quality measures Direct HHS to develop national quality strategy, public reporting Source: K. Davis, S. Guterman, S. R. Collins et al., Starting on the Path to a High Performance Health System: Analysis of Health System Reform Provisions of Reform Bills in the House of Representatives and Senate (New York: The Commonwealth Fund, Dec. 2009).

Total 10-Year NHE Savings Compared with Modified Current Projection Exhibit 12. Total National Health Expenditures (NHE), 2009–2019, Current Projection and Alternative Scenarios NHE in trillions 6.6% annual growth $4.8 $4.7 $4.5 6.4% annual growth 6.0% annual growth $2.5 Total 10-Year NHE Savings Compared with Modified Current Projection $1.090 Trillion * Modified current projection estimates national health spending when corrected to reflect underutilization of services by previously uninsured. Source: D. M. Cutler, K. Davis, and K. Stremikis, Why Health Reform Will Bend the Cost Curve (Washington and New York: Center for American Progress and The Commonwealth Fund, Dec. 2009).