uses of health care funds in the u.s. (2010) source: centers for medicare and medicaid services...
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Uses of Health Care Funds in the U.S. (2010)
Source: Centers for Medicare and Medicaid Services [2012c].
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Sources of Health Care Funds in the U.S. (2010)
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Source: Centers for Medicare and Medicaid Services [2012c].
The Advantages of Employer-Provided Health Insurance
• Increase the risk pool• Reduce adverse selection• Lower administrative costs
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Employer-Provided Health Insurance and Job Lock
• Job lock• Health Insurance Policy Portability and
Accountability Act of 1996 (Kennedy-Kassenbaum Act)
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Medicare Expenditures(1966-2010)
Expenditures on Medicare as a Share of GDP
Real expenditures on Medicare
Source: Centers for Medicare and Medicaid Services [2012c].10-5
How Medicare Works
• Eligibility: elderly over 65 and disable
• Financing– Payroll tax funds => Hospital Insurance– General revenues fund => Supplementary
Medical Insurance
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Cost Control Under Medicare
• Medicare’s retrospective payment system• Medicare’s prospective payment system:
setting fixed reimbursement level– Diagnosis related groups– Resource-based relative value scale system
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Medicare: Impacts on Spending and Health
• Expenditures on health care for the elderly• Has health improved?• Page 211
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Medicaid: Overview
• Medicaid• Eligibility: low – income people• State Children’s Health Insurance Program
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Medicaid Expenditures (1966-2010)
Source: Centers for Medicare and Medicaid Services [2012c].
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Financing and Administration
• Joint Federal-State financing• State administration
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Benefits
• States obligated to offer minimum package of benefits
• States may offer more generous benefits
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Health Care Costs and Health Outcomes:U.S., Canada, United Kingdom
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Final Thoughts
• Security vs. efficiency• No free lunch• Connection between health care expenditures
and healthhttp://www.ahrq.gov/
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