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Class 2: Estimating the size and structure of the US Health Industry -1980 to 2000. Two emphases: 1. The tools CMS uses to estimate size and structure of the US Health Industry 2. Interpreting the estimates published by CMS.
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Class 2: Estimating the size and structure of the US Health Industry -1980 to 2000 Two emphases: 1. The tools CMS uses to estimate size and structure of the US Health Industry 2. Interpreting the estimates published by CMS
U.S. National Health Accounts (NHA)(http://www.cms.gov/statistics/nhe) • Starting in 1964, HHS has published annual statistics on national health expenditures. • The NHA define sources of health expenditures and medical services exchanged for these expenditures. • By maintaining a consistent set of these definitions, the NHA can compare NHE over time. • Each health transaction is entered twice into the NHA - as an expenditure and a payment. This double-entry set-up enables NHA statisticians to compare expenditures against payments to check NHE estimates for accuracy.
The NHA Are Grouped Into Various Configurations That Measure Key Trends in Health Policy Debates (http://www.cms.gov/statistics/nhe/historical/t3.asp) • PHE as a portion of GDP • PHE by various sources of funds • Over time, changes in the sources-of-funds structure • Payments for various types of services • Over time, changes in the types-of-services structure • Projections
National Health Expenditures(NHE) by objects: • Health services and supplies • Personal Health Care (PHC) • Program administration and net cost of private health insurance • Government public health activities • Research and construction • Research • Construction
NHE by Sources of Funds • Out-of-pocket expenditure • Private health insurance • Non-patient revenue and philanthropy • Medicare • Medicaid • State and local government hospital subsidy • Other government programs (SCHIP)
Deflating PHC Expenditures • Deflating health care spending separates the effects of price growth from growth attributable to all other factors. • PHC expenditure fixed weight price index (M-CPI). Based on surveys taken by the Department of Labor. • M-CPI is used to deflate current annual estimates of personal health care expenditures. This technique is used to eliminate the impact of market changes on PHC expenditures. • Comments on current concerns about M-CPI