On February 2, 2012 NIHCM Foundation hosted a webinar, "Controlling Health Care Spending: The Imperative to Act and Diverse Views of the Road Forward." The U.S. now spends $2.5 trillion annually on health care, accounting for well over 17 percent of GDP and growing rapidly with challenging fiscal consequences. Despite the imperative to control spending, we face much uncertainty about how to move to a more sustainable path. Political opposition threatens implementation of the Affordable Care Act, and many of its cost-control measures are still unproven. A long-term fix for Medicare physician payment remains elusive. The trigger mechanism activated by the failure of the Super Committee is poised to affect myriad health programs, but decisions on the specific cuts await sure-to-be intense congressional negotiations. And the many ideas for entitlement reform that were advanced during deficit reduction talks continue to generate much debate but little consensus.

To shed light on these complex issues, this webinar featured leading health policy experts discussing topics including:

• health spending growth and the implications for government budgets, employers and individuals
• the societal trade-offs we face as health spending grows and as we think about ways to control spending
• alternative viewpoints on the viability of cost control approaches now being tried and the most promising options for the future

On July 19, 2011 NIHCM Foundation hosted a webinar, "Medicare and the Federal Deficit." Our federal government is spending vastly more than it is taking in, resulting in huge annual deficits that must be covered by borrowing. We now borrow about 41 cents for every dollar we spend and have reached our legal debt limit of more than $14 trillion, forcing contentious standoffs over raising the debt ceiling. The Congressional Budget Office predicts that our public debt will reach 70 percent of GDP this year and could exceed GDP within a decade – rivaling debt levels last seen during World War II. With Medicare spending accounting for 13 percent of federal spending or 3.7 percent of GDP today and projected to reach about 7 percent of GDP by 2035, this program is a significant contributor to our fiscal woes and an inescapable part of any solution.

Through presentations from three national experts, participants:

• learned how Medicare affects our fiscal outlook,
• heard about new data showing the large imbalance between lifetime Medicare benefits and contributions, and
• explored the range of Medicare reform options now under discussion and the political outlook for enacting reforms.

On February 14, 2011 NIHCM Foundaton hosted a meeting of experts at the L'Enfant Plaza Hotel in Washington, DC.

MAKING RISK ADJUSTMENT WORK IN HEALTH CARE REFORM: IDENTIFYING THE CHALLENGES AND POTENTIAL PATHS FORWARD

Risk adjustment will be a critical mechanism for ensuring the stability of the new health insurance exchanges that will begin in 2014 and achieving the promise of health reform with respect to expanded access to insurance coverage.  Many decisions and activities will be needed, however, between now and 2014 and even beyond in order to put an effective risk mitigation system into place, requiring close collaboration between federal and state policymakers, health insurers and other stakeholders.

This meeting brought together an outstanding group of 50 actuaries, economists, federal and state policymakers, health plan representatives, consultants and other stakeholders for a candid discussion of the challenges in developing and implementing risk adjustment under health reform and potential ways to address these challenges.

 Additional Information

•  AGENDA
• SPEAKER BIOGRAPHIES
• SPEAKER PRESENTATIONS
  • Robert Kocher, MD, McKinsey Center for Health Reform and Nonresident Senior Fellow at The Brookings Institution
  • Rong Yi and James O'Connor , Milliman
  • Ross Winkelman , Wakely Consutling
• MEETING BIBLIOGRAPHY
• PARTICIPANTS LIST 
  • Ian Duncan, FSA, published a new book on risk adjustment

On June 26, 2009 NIHCM hosted a policy briefing on Capitol Hill.

THE FUTURE OF HEALTH CARE IN AMERICA: A POLICY FORUM

• When: Friday June 26, 2009, 9am to 12pm (breakfast served at 8:30am)
• Where:  Rayburn Office Building, Room B339

A distinguished panel of policy experts and marketplace leaders engaged in a wide-ranging discussion of the future of health care in America, providing a broad perspective on the major issues facing the Obama administration and Congress as they tackle health care reform this year

Additional Information

• Video Archive as broadcast on CSPAN
• AGENDA
• SPEAKER BIOGRAPHIES
• SPEAKER PRESENTATIONS
  
  • Robert Reischauer, The Urban Institute
  • Cleve Killingsworth and Andrew Dreyfus, Blue Cross Blue Shield of Massachusetts
  • Paul Ginsburg, Center for Studying Health System Change
  • Patrick Geraghty, Blue Cross Blue Shield of Minnesota
  • Mark McClellan,  The Brookings Institution
  • Uwe Reinhardt, Princeton University; also see his New York Times blog, Economix

NIHCM hosted a conference on December 1, 2008 at the St. Regis Hotel in Washington, DC. 

MANAGING HEALTH SYSTEM CAPACITY: MARKET AND POLICY APPROACHES

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. A better understanding of the effects and drivers of capacity changes and identification of strategies to manage capacity growth are essential for improving the efficiency and quality of our health care system.

The conference provided an in-depth examination of the critical issues surrounding health system capacity:

• How does the supply of hospitals, physicians, and other health care providers affect utilization of services, health spending, and quality of care?
• How can pricing be improved to remove distortions that influence relative prices and drive capacity investments and use?
• What types of informational, organizational and financial changes could help to align providers’ incentives to deliver care more efficiently?
• What are private-sector payers and providers doing to promote more efficient use of existing capacity?
• Is state health planning an effective tool for managing system capacity?

Additonal information:

• Agenda
• Conference Video
• Speaker Biographies
• Speaker Presentations
• The Challenges of Health System Capacity Growth by Laurence C. Baker, PhD
• Bibliography of Relevant Literature

NIHCM funded a white paper, produced by the Barents Group LLC (now BearingPoint), analyzing the wide variety of markets for health insurance, the many state approaches to regulation, and potential effects of federal and state reform on this fragile market. It was presented at a National Health Policy Forum briefing. A series of three issue briefs on the subject are also available. See Health Care Reform Publications .

NIHCM Foundation produced a series focused on state and private sector efforts to reform health care. It included reports on health care problem variations; Medicaid managed care; state employee benefit programs and types of state health care reform. See Health Care Reform Publications.