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THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN

THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN. Osaka March 1, 2014 Tokyo March 2, 2014 Lee Pickler, DBA. ACUTE CARE IN THE UNITED STATES ROLE OF LTAC’s. CURRENT HIGHLIGHTS OF HEALTHCARE TODAY

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THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN

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  1. THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN Osaka March 1, 2014 Tokyo March 2, 2014 Lee Pickler, DBA

  2. ACUTE CARE IN THE UNITED STATESROLE OF LTAC’s • CURRENT HIGHLIGHTS OF HEALTHCARE TODAY • UNTIL 2013 HEALTHCARE COSTS HAVE INCREASED EITHER ALARMINGLY OR AT LEAST SIGNIFICANTLY • FORTY-SEVEN MILLION AMERICANS EITHER UNDER-INSURED OR UNINSURED • THE DEMOGRAPHICS WILL NOT IMPROVE THE SITUATION—ONLY WORSEN IT • THE PRIVATE SECTOR HAS NOT BEEN ABLE TO ADDRESS THE PROBLEM • THE AFFORDABLE CARE ACT IS THE GOVERNMENT’S RESPONSE TO THE PROBLEM

  3. THE ENVIRONMENT • DEMOGRAPHICS • MACRO ECONOMICS • HEALTHCARE RESOURCES • PUBLIC SECTOR

  4. Japan United StatesDemographic Comparisons 2012 Population Japan 127,515,000 U.S. 313,914,000 2013 Elderly (65+) %tage of Population Japan 23.7% U.S. 13.9%

  5. Projection of Population over 80 Years

  6. Notes on Japan -- LTC • Japan public spending on long-term care is projected to more than double from 1.4% in 2007, and could even reach 4.4% of GDP in 2050. Japan’s real public LTC spending is expected to grow at a faster rate between 2006 and 2025. • Highlights fromHelp Wanted? Providing and Paying for Long- Term Care, OECD Publishing, 2011.

  7. Japan United StatesMacro Economic Comparisons 2010 Health Expense Per Capita Japan $3,958 U.S. $8,233 Health Cost %tage covered by the public (2011) Japan 80.0% U.S. 45.9% http://www.oecd.org

  8. Japan United StatesMacro Economic Comparisons • 2012 GDP Per Capita (in U.S. Dollars): • Japan US$46,720 • U.S. US$49,965

  9. RESOURCES • Acute Care Beds Density per 1000 (2011) • Japan – 8 (Avg length of stay 17.9) • U.S. -- 2.6 (Ave length of stay 4.8) • Physician Density per 1000 (2010) • Japan – 2.23 • U.S. -- 2.44

  10. FIND A NEED AND FIX IT • GOVERNMENT POSITION—REGULATE AND PRICE FIX. RESULT WILL BE ADJUSTMENTS MADE BY THE PRIVATE SECTOR TO ADDRESS THE PROBLEM. • PRIVATE SECTOR CHANGED ACORDING TO WHO HAD THE POWER. • PHYSICIAN POWER, INSUROR POWER

  11. THE RESULT • NO INCREASE IN PATIENT ACCESS • INCREASED COST OF CARE • DUE TO THIRD PARTY PAYORS • TECHNOLOGY • SERVING THE UNDER-SERVED • NOTHING FIXED SO THEREFORE: • OBAMA CARE (THE AFFORDABLE CARE ACT)

  12. TWO CHALLENGES • ACCESS TO CARE FOR EVERYONE • IMPROVE COVERAGE • DRIVE COST OUT • SOME METHODS: • REGULATE INSURORS • CONTROL/DECREASE REIMBURSEMENT • BEGIN TO BUNDLE PRICING • DON’T PAY FOR MISTAKES

  13. DELIVERING CARE IN THIS ENVIRONMENT • SHORT TERM ACUTE CARE • LONG TERM ACUTE CARE • INPATIENT REHABILITATION • SKILLED NURSING FACILITY • HOME CARE

  14. A Comparison of Facilities

  15. LTACH DEFINITION • LONG TERM ACUTE CARE HOSPITALS PROVIDE SPECIALIZED ACUTE CARE FOR MEDICALLY COMPLEX PATIENTS WHO ARE CRITICALLY ILL WITH MULTI-SYSTEM COMPLICATIONS AND REQUIRE LONG HOSPITALIZATIONS.

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