the commonwealth fund making care more efficient: promising innovations and policy options karen...
TRANSCRIPT
THE COMMONWEALTH
FUND
Making Care More Efficient: Promising Making Care More Efficient: Promising Innovations and Policy OptionsInnovations and Policy Options
Karen DavisPresident
The Commonwealth Fund
Bipartisan Health Policy ConferenceMiami, FL
January 12-14, 2007
International Comparison of Spending on Health, 1980–International Comparison of Spending on Health, 1980–20042004
0
1000
2000
3000
4000
5000
6000
7000
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
United StatesGermanyCanadaFranceAustraliaUnited Kingdom
Data: OECD Health Data 2005 and 2006.
0
2
4
6
8
10
12
14
16
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
United StatesGermanyCanadaFranceAustraliaUnited Kingdom
Average spending on healthper capita ($US PPP)
Total expenditures on healthas percent of GDP
Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2006
EFFICIENCY
2
Health Expenditure Growth 2000–2005Health Expenditure Growth 2000–2005for Selected Categories of Expendituresfor Selected Categories of Expenditures
13.9
5.78.4 8.2 8.5
5.9
11.8
5.87.37.07.96.9
0
5
10
15
20
Total nationalhealth
expenditures
Hospital care Physician &clinical services
Nursing home &home health
Prescriptiondrugs
Prog. admin. &net cost of
private healthinsurance
2000–2004 2005
Average annual percent growth in health expenditures
Source: A. Catlin et al., “National Health Spending in 2005: The Slowdown Continues,” Health Affairs, Jan./Feb. 2007 26(1):142-153.
Percentage of National Health Expenditures Spent on Health Percentage of National Health Expenditures Spent on Health Administration and Insurance, 2003Administration and Insurance, 2003
Net costs of health administration and health insurance as percent of national health expenditures
1.9 2.1 2.12.6
3.34.0 4.1 4.2
4.85.6
7.3
0
2
4
6
8
France
Finla
nd
Japan
Canad
a
Unite
d Kin
gdom
Nether
lands
Austri
a
Austra
lia
Switzer
land
Germ
any
Unite
d Sta
tes
a b c *
a 2002 b 1999 c 2001* Includes claims administration, underwriting, marketing, profits, and other administrative costs; based on premiums minus claims expenses for private insurance.Data: OECD Health Data 2005.
Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2006
EFFICIENCY
THE COMMONWEALTH
FUND
Growth in National Health Expenditures (NHE) Growth in National Health Expenditures (NHE) Under Various ScenariosUnder Various Scenarios
Source: Based on Borger et al., “Health Spending Projections Through 2015: Changes on the Horizon,” Health Affairs Web Exclusive, February 22, 2006.
NHE, in trillions of dollars
1.75
2.25
2.75
3.25
3.75
4.25
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Baseline NHEOne-time savings scenarioSlowing trend scenario
$2.016 trillion in 2005
Cumulative savings projections, 2007–2015:One-time savings: $1.31 trillionSlowing trend: $1.39 trillion
$3.710 T$3.849 T
$4.037 T
THE COMMONWEALTH
FUND
Strategies for Achieving a More Efficient Strategies for Achieving a More Efficient Health SystemHealth System
• Increasing the effectiveness of markets – Better information on provider quality, prices and total costs
for episode of care– Better information on the cost-effectiveness of health care
technology and procedures• Providing payment incentives to promote efficient and effective
care• Changing the health care system to promote patient-centered
primary care• Investing in infrastructure such as health information technology
and information exchange systems and technical assistance for quality and efficiency improvement
• Reducing insurance administrative overhead and achieving more competitive prices
• Investing strategically to improve access, affordability, and equity