Case Study: Health Care Spending

Health Care Reform Project:
Health Care Spending
Tracey Loftus, Javelin Freeland, Mariah Jones, and Rochelle Foster
HCS 440
October 20, 2014
Dawn Chiabotti

Introduction
Health Care Costs
Methods and Tools used

to address challenges
Prescription Drugs
Uninsured

How it all relates to health

care reform
Prescription Drugs
Uninsured

Solution that is most

effective/payment sources involved Steps needed to implement solution Health Care Cost

Medical Cost Drive Growth
Spending Breakdown
Hospital Cost Increase
Provider Prices
Medical Technology

Retrieved from http://www.aetna.com/assets_aet naCom/images/aetnaCom_rebran d/CenterChannel_PromoBox/Abo ut_Aetna/Health_Care_Initiatives/
Illustrations/HC-cost-chart1.gif.

Health
Care Cost cont.
Spending Breakdown Cont.
Waste
Unhealthy Lifestyles
Aging Population

Retrieved from http://economiccollapsenews.c om/wpcontent/uploads/2013/04/Healt hcare_costs_small1.jpg. Prescription Drugs
Brand name drugs

make up 48% of prescriptions drugs
Brand name drugs prices continue to increase Physicians have the right to order prescription drugs
Rising costs will affect health insurance plans

Image Retrieved from http://bestefits.com/wpcontent/uploads/2014/03/he althcare-reform.jpg

The Uninsured
50% of bankruptcies are

related to medical bills
In 2012, 85 million people were uninsured
16% of people experienced expensive out-of-pocket fees In 2012, 41% of

patients had a challenging time paying medical bills

Image Retrieved from http://www.finalcall.com/a rtman/uploads/1/uninsure d300x225_1.jpg How Prescription Drug Costs Relate to
Health Care Reform
Prescription drug costs

reach $262 billion in 2010
Generic drugs vs Brand name drugs
Medicare vs.
Medicaid

How The Uninsured Relate to Health Care
Reform
Medicaid offered to qualifying uninsured individuals
The uninsured may remain uninsured
Health premiums for young adults will increase by 17%
Health care overhaul lose of coverage

Effective Solutions for Health Care Reform
Fight Chronic Conditions
Reduce Medical Errors
Health Challenges
Healthy Habits

E-Prescribe
Retail (Minute) Clinics
Shared Information
Set Goals for Treatment
Hospital Team Ups

Effective Solutions for Health Care Reform
Cont.
Unnecessary
Treatment
Reduce Infant Mortality
Make School Healthier
Electronic Medical

Records
Saving Primary Care

Affordable Drugs
Virtual Doctors (Online

Physicians)
Best Affordable Health
Insurance

Payment Source for Effective Solutions
Medicare
Medicaid
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Point of Service Plan (POS)
State Children Health Insurance Program

(SCHIP)

Implement Solution
New laws to protect guaranteed benefits for all Medicare

beneficiaries
Provide new benefits and services to seniors on Medicare
Improve quality
Develop and promote new models of care delivery
Appropriate price service
Modern health care system
Fight waste, fraud and abuse

Implement Solution
Affordable Care Act

Retrieved from http://www.cms.gov/apps/doc/acaupdate-implementing-medicarecost-savings.pdf Medicare Spending

Conclusion
Health Care Costs
Prescription Drugs
Uninsured
Related to Health Care Reform
Prescription Drugs
Uninsured
Implement Solution

References
Aetna, (2013). The Facts About Rising Health Care Costs. Retrieved from http://www.aetna.com/health-reform-

connection/aetnas-vision/facts-about-costs.html.
Data Analysis of the Affordable Care Act, CMS Office of Actuary, (2010). Retrieved from http://www.cms.gov/apps/doc/aca-update-implementing-medicare-cost-savings.pdf Eighteen Ideas to Reform Health Care, Readers Digest, (2014). CEO of The Kaiser Foundation Health Plan Dr. Cortese, &
G. Halvorson, Retrieved from http://www.rd.com/health/healthcare/18-ideas-to-reform-health-care-now
Health Care Problems.
(2014). Health Care Statistics . Retrieved from http://www.healthcareproblems.org/health-carestatistics.htm
Langreth, R. (2014, May). Big pharma 's favorite prescription: higher prices. , (), . Retrieved from http://www.businessweek.com/articles/2014-05-08/why-prescription-drug-prices-keep-rising-higher Medicare & Medicaid Health Care, (2014). Retrieved from http://kff.org.medicare/medicaid/the -Medicare-Medicaidprogram-at-a-glance,
Humana Health Insurance Company, (2014). Medicare and Medicaid Solutions. Retrieved from http://www.humana.com
Wang, A.L. (2014, September). Why your 2015 health coverage will cost more. Retrieved from http://www.chicagobusiness.com/article/20140906/ISSUE01/309069984/why-your-2015-health-coverage-will-cost-more deBruyn, J. (2012). How drug costs impact health care reform. Triangle Business Journal .
Nix, K. (2010, April 10). Obamacare: Impact on the uninsured. Retrieved October 18, 2014, from The Heritage
Foundation: http://www.heritage.org/research/reports/2010/04/obamacare-impact-on-the-uninsured
What the Affordable Care Act Means for Prescription Coverage. (2014, March 7). The Washington Post .
Why generic drugs. (2012). Retrieved October 17, 2014, from Offshore Rx:
http://www.offshorerx.com/why_generic_drugs.php