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Health Care Costs :  Managed Care, Prospective Payment, and  Reimbursement Trends

Explore the landscape of health care costs, managed care, reimbursement trends, and the role of insurance in the U.S. health care system. Understand key statistics on spending, insurance sources, and support for system reform. Delve into efforts by organizations like the AMA to promote health, reduce costs, and improve care delivery. Learn about the impact of chronic diseases, Medicare challenges, and the reality of health care reform initiatives. Stay informed on key issues shaping the future of health care in America.

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Health Care Costs :  Managed Care, Prospective Payment, and  Reimbursement Trends

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  1. Health Care Costs: Managed Care, Prospective Payment, and Reimbursement Trends

  2. Where does insurance come from? Employer-sponsored 61% Private/ Non-group 5% Uninsured 18% Medicaid/ Public Health Insurance 16%

  3. Family health coverage in MI

  4. Cutting back on care

  5. U.S. Health Care Spending 2018: $4.4 Trillion 2008: $2.4 Trillion

  6. 5 American College of Physicians, Ann Intern Med 2008;148:55-7

  7. Percentage of national health expenditures spent on health administration, 2003 American College of Physicians, Ann Intern Med 2008;148:55-75

  8. Support for Health System Reform “We can no longer afford to put health care reform on hold.” ~ President Barack Obama, Feb. 24, 2009 “Rising health costs undermine our strength in the global marketplace.” ~ Sens. Baucus and Kennedy, Feb. 26, 2009 WSJ “We can achieve health-care reform in America . . . if we do it in a truly bipartisan basis.” ~ Sen. John McCain, Feb. 25, 2009, CNN

  9. Commitment “You have our commitment to play, to contribute and to help pass healthcare reform this year.” ~ AHIP Chief Executive Karen Ignagni, at the Obama health care summit, March 5, 2009

  10. AMA working closely with: • Obama Administration • Senate HELP and Finance • House Ways and Means; Energy and Commerce • Health Reform Dialogue Group • State attorneys general • State medical societies

  11. Health System Reform • Provide health care coverage for all • Improve quality • Promote wellness and prevention • Reform public programs • Reform health care delivery systems • Reduce cost and increase value

  12. 46 million uninsured Americans is a national disgrace

  13. The AMA Plan • Affordability • Choice • Fairness

  14. Promoting health and wellness

  15. Determinants of health

  16. www.ama-assn.org/go/lifesteps

  17. Annual costs of chronic disease • Heart disease and stroke $448B • Smoking and tobacco use $193B • Diabetes $174B • Obesity $117B • Cancer $89B • Arthritis $81B • Pregnancy complications $1B • (pre-delivery)Total = $1.1Trillion Source: http://www.cdc.gov/nccdphp/overview.htm

  18. The Medicare Dilemma Practice Costs Medicare Cuts

  19. Michigan physicians likely would…

  20. Stimulus Rhetoric vs. Reality • Health Information Technology (HIT) • Comparative Effectiveness Research (CER) • The first step toward health system reform • www.ama-assn.org/go/patients

  21. THANK YOU!

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