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Understanding U.S. Health Care Spending. In this data brief we examine why we spend more than $8,000 per person on health care and the factors driving spending growth. Our analyses document the extreme concentration of expenditures, with just 5 percent of the population responsible for almost half of all spending, and demonstrate the importance of rising spending for hospital and physician services as the primary drivers of expenditure growth. By Julie Schoenman, Ph.D., and Nancy Chockley, M.B.A., NIHCM Foundation, July 2011.
The Challenges of Health System Capacity Growth (Research Brief). The number of hospitals, physicians and other providers affects the amount of care delivered to American patients and the value received from our health care spending. Some capacity expansions produce benefits that exceed their costs, yet the reverse may be true when overuse of expensive goods and services occurs. By Laurence Baker, Ph.D., Professor of Health Research and Policy, Stanford University, November 2008.
Expert Voices: Chronic Conditions. The cost and prevalence of chronic conditions are increasing. A response is overdue. By Gerard Anderson, Ph.D., Professor, Johns Hopkins University, and Director, Partnership for Solutions, January 2002.
Expert Voices: Racial and Ethnic Disparities in the U.S. The elimination racial and ethnic health disparities must become one of the nation's top health priorities. By David Satcher, M.D., Surgeon General of the United States, December 2001.
Expert Voices: Paying Doctors. Paying doctors is now very complex, but a better way may be emerging that promotes higher quality care. By Jamie C. Robinson, Ph.D., Professor of Health Economics, University of California, Berkeley, July 2001.
Expert Voices: Evidence-Based Medicine. A paradigm shift is underway in health care. It will change medical practice in the years ahead. By John M. Eisenberg, M.D., Director, Agency for Healthcare Research and Quality, January 2001.
Health Care System DataSource, Second Edition, National Institute for Health Care Management, November 1998, 575 pp., (out of print). A compilation of health system data at the national, state and local (metropolitan statistical area) level. The second edition is reformatted with state and MSA data grouped by state and contains comparison tables. Year of data varies. Non-proprietary data is available on disk or electronically to book purchasers.
State Regulation of the Individual Health Insurance Market (Issue Brief), State Individual Insurance Markets and Impacts of Federal Reform, Barents Group, LLC, 1997, 6 pp., first in a series. This issue brief provides an overview of select individual market regulations in each of the 50 states prior to the enactment of the federal Health Insurance Portability and Accountability Act of 1996. The brief presents state regulations related to rating restrictions, guaranteed issue and preexisting condition limitations.
Characteristics of Current and Potential Purchasers of Individual Health Insurance (Issue Brief), State Individual Insurance Markets and Impacts of Federal Reform, Barents Group, LLC, 1997, 6 pp., second in a series. This issue brief describes the 1996 employment, income and demographic characteristics of non-group purchasers, the uninsured and three subsets of the uninsured: individuals who appear to have enough financial resources to purchase health insurance, the self-employed, and children.
State Experiences with Individual Insurance Market Reform (Issue Brief), State Individual Insurance Markets and Impacts of Federal Reform, Barents Group LLC, 1997, 6 pp., third in a series. This issue brief examines changes in state regulation of the individual health insurance market that were implemented prior to the enactment of federal health insurance reform in 1996. It analyzes the legislation enacted and its impact on market composition, premiums and enrollment in four states that have had different experiences: Washington, New York, New Jersey and Wisconsin.
State Individual Health Insurance Markets and Impact of Federal Reform, Barents Group, LLC, May 1996, 41 pp. This report develops a typology of individual insurance market regulations along three dimensions: medical underwriting and ratings restrictions, guaranteed issue and pre-existing condition limitations. It also examines the impact of legislation on the individual insurance markets in New York and Washington and summarizes legislative proposals pending before Congress in early 1996: the Health Insurance Reform bill (S.1028), the Health Coverage Availability and Affordability Act of 1996 (H.R. 3103) as well as the National Association of Insurance Commissioners Model Act.
Health Care System DataSource, National Institute for Health Care Management, October 1996, 603 pp., (out of print). A compilation of health system information including consumer, payer, provider and policy data at the national, state and local (metropolitan statistical area) levels. Year of data varies.
State Health Care Reform: Recent Activity, The States and Private Sector: Leading Health Care Reform, Lewin-VHI/Alpha Center, May 1995, 57 pp., fourth in a series. States vary in their efforts at health care reform, and this report attempts to clarify whether there is a correlation between the number of initiatives and actual achievements in health care reform goals. The report categorizes state health care reform strategies and systematically compares these reforms in two indices: an access reform index and an overall reform index.
States As Purchasers: Innovations in State Employee Health Benefit Programs, The States and Private Sector: Leading Health Care Reform, Lewin-VHI, April 1995, 51 pp., third in a series. This report provides information on public employee health benefit plans (PEHBP), and presents new information on variations across states in their efforts to provide cost-effective coverage. This report examines the role of the public and private sectors in developing and implementing PEHBP purchasing strategies and also discusses implications for policy makers.
States As Payers: Managed Care for Medicaid Populations, The States and Private Sector: Leading Health Care Reform, Lewin-VHI, February 1995, second in a series. This report provides an overview of Medicaid managed care. It includes a description of the three major models of managed care implemented by states, an examination of variation in recipients and areas covered, an analysis of the effect of mandatory versus voluntary enrollment, and a comparison to private sector managed care. The paper presents an analysis of the type and extent to which Medicaid managed care has been implemented in each of the 50 states as of June 1994.
Health Care Problems: Variation Across States, The States and Private Sector: Leading Health Care Reform, Lewin-VHI, December 1994, 67 pp. This paper analyzes state-to-state variation on health care problems. The measures include number of uninsured as a percent of total population, per capita health expenditures as a percent of per capita gross state product, health outcomes and size of "vulnerable" populations.
Medical Necessity, Experimental Treatment and Coverage Determinations: Lessons from National Health Care Reform, National Institute for Health Care Management, October 1994, 45 pp. This paper explores the need to define coverage and resolve disputes in ways that make sense for future health care financing and delivery. It identifies key issues affecting determinations of necessity or appropriateness of medical treatment, using legislation considered by the 103rd Congress to illustrate the pros and cons of various approaches.
Health Plan Solvency Under Health Care Reform, National Institute for Health Care Management, May 1994, 18 pp. Health plan insolvency is an indication of an inability to compete in the marketplace. This paper examines elements in the 1993-94 health care reform proposals that increased the risk of insolvency, mechanisms to limit and prevent insolvency, and devices to deal with insolvency when it occurs.
Health Information Needs of Policy Makers and Opinion Leaders: A Survey, Louis Harris and Associates, 1993, 132 pp. NIHCM commissioned this study to assess the informational needs of policymakers, through interviews with health care experts and Congressional staffers.