US and Internati onal Health Care: Trends in Spending, Costs and Prices Presentation to Society of American Business Editors and Writers By Susan Dentzer October 27, 2014
Jan 01, 2016
US and International Health Care:
Trends in Spending, Costs and Prices
Presentation to Society of American Business Editors and WritersBy Susan DentzerOctober 27, 2014
2International Comparison of Spending on Health
1980-2008
Average spending on healthper capita ($US PPP)
Source: OECD Health Data 2010 (June 2010).
Total expenditures on healthAs a share of GDP
International Slowdown in Health Cost Growth ?
Source: Lorenzoni L, Belloni A, Sassi F, “Health-care expenditure and Health Policy In the USA versus other high-spending OECD Countries,” The Lancet, 2014; 384:83-92
Annual Growth Rates, Gross Domestic Product (GDP) And National Health Expenditures (NHE), Calendar Years 1990–2023.
Sisko A M et al. Health Aff doi:10.1377/hlthaff.2014.0560
Health Spending Projections, CMS
Exchanges, subsidies and Medicaid expansion
2% gapremains;cost curvenot bent
The Role of Prices
• Since 2000, rising prices of hospital charges,
professional services, drugs, devices, and
administration costs have produced 91 percent of the
increases in health spending
• US prices for almost every aspect of health care
greatly exceed those in all other high-income
countries
• Sources: Moses H et al, “The Anatomy of Health Care in the United States,” JAMA 2013; 310(18):1947-1964;
International Federation of Health Plans
International Price Variation: An Example
“At $84,000, Gilead Hepatitis C
Drug
Sets Off Payer Revolt”
Bloomberg.com, Jan. 27, 2014
Specialty Pharmaceuticals: The Case of Sovaldi
High Cost-Sharing in Exchange Plans
Exchange plans at lower tiers impose high cost-sharing requirements on individuals before they reach their out-of-pocket maximums.
Source: Avalere Health
More than double the average deductible in an employer-provided plan
All-Payer Claims Databases
States Move To Require Health Care Price Transparency
Cost estimator toolallows patients to calculate what they will pay out-of-pocket
e.g., for a Medicare patient receiving a hip replacement, $5207
Disruptive Technologies: Potential to Lower Spending?
• Digital health, mhealth
(mobile), apps
• Pushing care out of
institutions and into homes
and offices
• Enabling more self care
• Engaging patients and enhancing sense of knowledge, confidence, activation
New entrants into health care: Apple
• Apple Health dashboard allows consumers to compile and view health care information
• Apple’s HealthKit: new platform for health apps
• Apple Watch has heart rate sensors; annual sales of 485 million predicted
• Link with Epic EHR• Exploring incorporation of blood
pressure and glucose monitoring into iPhone
The End