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A Satellite Account of U.S. Health Care Spending: Plans and progress

A Satellite Account of U.S. Health Care Spending: Plans and progress. Brian C. Moyer Associate Director for Industry Accounts. 12 th OECD-NBS Workshop on National Accounts Paris, France October 27-31, 2008. Health care spending as a percent of GDP. Source: U.S. Bureau of Economic Analysis.

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A Satellite Account of U.S. Health Care Spending: Plans and progress

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  1. A Satellite Account of U.S. Health Care Spending: Plans and progress Brian C. Moyer Associate Director for Industry Accounts 12th OECD-NBS Workshop on National Accounts Paris, France October 27-31, 2008

  2. Health care spending as a percent of GDP Source: U.S. Bureau of Economic Analysis

  3. Health care spending in BEA’s accounts • National income and product accounts • Consumer spending on health care • Investment in health care equipment • Contribution of health care to real GDP growth • Industry accounts • Input-output accounts—detailed transactions for the health care industries • GDP-by-industry accounts—real value added for the health care industries

  4. Conceptual model of a national health account Source: Beyond the Market: Designing Nonmarket Accounts for the United States (National Research Council, 2005)

  5. BEA’s Health Care Spending Satellite Account Focuses on three primary areas: • Reconcile National Health Expenditure Accounts and National Income and Product Account measures • Develop disease-based statistics for health care spending • Develop disease-based price indexes for health care spending

  6. Treatment substitution: An example • Assumptions: • No price change for either type of treatment • No change in number of patients Cost of Cataract Surgery price In patient • Problem: As patients use outpatient services, • Nominal expenditures fall • Treatment prices show no change • “Real” spending falls, even though quantities did not Out patient time Previous studies suggest this issue is numerically important.

  7. Disease-based price indexes: Early research Comparison of disease- and provider-based indexes • Features of index: • Constructed using large claims database for HMO patients • Price = revenue from all sources • Price is defined as price per patient treated for a homogeneous condition • Dollars are allocated to conditions using “episode groupers” • “Providers” are identified using “place of service” variable Provider-based Disease-based Source: Aizcorbe and Nestoriak (2008)

  8. Accounting framework: Initial thoughts • Consumer spending organized by type of disease • Primary caregiving industry provides health care services using inputs from other health care industries, such as hospitals, laboratories, and pharmacies • Productivity gains allocated across industries

  9. Routing of industry transactions Industry that provides health care  Other industries provide Intermediate inputs

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