Emerging Trends in Healthcare Greg Moody Executive in

  • Slides: 15
Download presentation

Emerging Trends in Healthcare Greg Moody, Executive in Residence John Glenn College of Public

Emerging Trends in Healthcare Greg Moody, Executive in Residence John Glenn College of Public Affairs moody. 67@osu. edu Single Payer Healthcare: How might it affect you and your patients? Columbus Medical Association November 7, 2019

Problems Policies Policy Window Politics

Problems Policies Policy Window Politics

Equality Health Policy The state of being equal – a person considered to be

Equality Health Policy The state of being equal – a person considered to be the same as another – especially in status, rights, and opportunities. Liberty The state of being free within society from oppressive restrictions imposed by authority on one's way of life, behavior, or political views.

Equality The state of being equal – a person considered to be the same

Equality The state of being equal – a person considered to be the same as another – especially in status, rights, and opportunities. Liberty The state of being free within society from oppressive restrictions imposed by authority on one's way of life, behavior, or political views.

Equality The state of being equal – a person considered to be the same

Equality The state of being equal – a person considered to be the same as another – especially in status, rights, and opportunities. Liberty The state of being free within society from oppressive restrictions imposed by authority on one's way of life, behavior, or political views.

Not everyone is covered Costs are too high Quality could be better Problems Policies

Not everyone is covered Costs are too high Quality could be better Problems Policies Medicare for All Politics

Vermont Single Payer Health Plan Estimated variables Savings (%) New employer taxes New employee

Vermont Single Payer Health Plan Estimated variables Savings (%) New employer taxes New employee taxes Total cost 2011, Harvard 2013, UMass 2014, State of VT 8 -12% short-term 24 -25% long-term 1. 5% over 3 years 1. 6% over 5 years 9. 4% of payroll Not estimated 11. 5% of payroll 3. 1% of household income Not estimated Sliding scale up to 9. 5% of household income Not calculated $3. 5 billion $4. 3 billion “I have learned that the limitations of federal law, the limitations of our tax capacity, and the sensitivity of our economy make [implementing a single-payer plan] unwise and untenable at this time. The risk of economic shock is too high. ” — Vermont Governor Peter Shumlin (December 17, 2014) John Mc. Donough, “The Demise of Vermont’s Single-Payer Plan, ” the New England Journal of Medicine (April 23, 2015).

Not everyone is covered Costs are too high Quality could be better Problems Policies

Not everyone is covered Costs are too high Quality could be better Problems Policies Medicare for All Politics Intense but limited political support Public unsure Distraction

Political Concerns about Medicare-for-All Would Medicare-for-all force millions of families off their insurance? Would

Political Concerns about Medicare-for-All Would Medicare-for-all force millions of families off their insurance? Would Medicare-for-all raise taxes on the middle class? Would single-payer devastate rural hospitals? Jeff Stein, “Here are the Democrats’ three key disputes about Medicare-for-All, ” The Washington Post (July 31, 2019).

Support for Medicare-for-all has narrowed over time SOURCE: Kaiser Family Foundation Health Tracking Polls

Support for Medicare-for-all has narrowed over time SOURCE: Kaiser Family Foundation Health Tracking Polls (November 2019).

Not everyone is covered Costs are too high Quality could be better Problems Policies

Not everyone is covered Costs are too high Quality could be better Problems Policies Medicare for All Politics Intense but limited political support Public unsure Distraction

Current health expenditure per capita (in current US$) $10, 000 $9, 000 United States

Current health expenditure per capita (in current US$) $10, 000 $9, 000 United States in red $8, 000 $7, 000 $6, 000 $5, 000 $4, 000 $3, 000 $2, 000 10 highest-income Western countries in gray $1, 000 $0 0 2001 2 2003 2004 2005 4 6 2007 8 2009 10 2011 12 2013 14 2015 16 World Bank Current Health Expenditure Per Capita in the countries the 11 Western countries with the highest gross domestic product (GDP) per capita according to the World Bank (2017), including Austria, Denmark, Germany, Iceland, Ireland, Luxembourg, Netherlands, Norway, Sweden, Switzerland the United States.

Health Care Expenditures per Capita by Service $3, 900 Hospital Care (Ohio +24%) $3,

Health Care Expenditures per Capita by Service $3, 900 Hospital Care (Ohio +24%) $3, 500 $3, 000 $2, 500 Physician and Clinical Services (Ohio -5%) $2, 000 $1, 500 Prescription Drugs (Ohio -8%) $1, 000 Nursing Home Care (Ohio +26%) $500 $0 2002 2004 2006 United States 2008 2010 2012 2014 Ohio Kaiser Family Foundation, Health Care Expenditures per Capita by Service by State of Residence (2000 -2014)

Alternative Payment Models (APM) Framework Advanced APMs Innovation in care delivery Innovation in payment

Alternative Payment Models (APM) Framework Advanced APMs Innovation in care delivery Innovation in payment to support care delivery Centers of Excellence (COE) Shared savings Patient-Centered Medical Homes (PCMH) Pay-for-performance Accountable Care Organizations (ACO) Bundled payment Shared risk Global budget / capitation 36% of health care payments in 2018 SOURCE: Health Care Payment Learning & Action Network (October 2019).