1 / 31

Variation in Medicare Spending: Some Regions Already Spend at Canadian Level

Variation in Medicare Spending: Some Regions Already Spend at Canadian Level. Overuse of Cardiac Stents. 15% of all stent procedures are appropriate - for acute heart problems (ACS) But, 85% of stents are done for stable heart problems, where no better than simple drugs.

justis
Télécharger la présentation

Variation in Medicare Spending: Some Regions Already Spend at Canadian Level

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Variation in Medicare Spending: Some Regions Already Spend at Canadian Level

  2. Overuse of Cardiac Stents • 15% of all stent procedures are appropriate - for acute heart problems (ACS) • But, 85% of stents are done for stable heart problems, where no better than simple drugs. • Patients treated only with drugs are 11% more likely to eventually need a procedure. • Hence, 62-75% of PCIs are unnecessary, costing $13- 15 billion/year (of the total $20,000 spent on stents).

  3. Quality of Care Slightly Better in Canada Than U.S. A Meta-Analysis of Patients Treated for Same Illnesses (U.S. Studies Included Mostly Insured Patients) Source: Guyatt et al, Open Medicine, April 19, 2007

  4. For-Profit Hospitals’ Death Rates are 2% Higher Source: CMAJ 2002;166:1399

  5. For-Profit Hospitals Cost 19% More Source: CMAJ 2004;170:1817

  6. For-Profit Dialysis Clinics’ Death Rates are 9% Higher Source: JAMA 2002;288:2449

  7. New Bad Ideas from the Private Insurance Industry • Consumer-directed care = skimpy coverage • Individual mandates like Massachusetts (force the uninsured to buy “skimpy coverage”) • Corporate disease management – replace primary care with firms that manage care for patients with diabetes, heart failure, etc. • Let private insurers compete with Medicare or similar program

  8. Walmart’s Plan: Attract Young, Healthy Workers by CDHP + Mandatory Physical Exertion Actual copy of internal memo from VP for Benefits to Walmart’s Board of Diectors, 2005

  9. Individual Mandates • MA law • Proposed in NY and IL • Component of plans by Edwards, Obama and others

  10. Crimes and Punishments in Massachusetts

  11. Corporate Disease Management Programs • No evidence that any disease management program lowers costs. • Fair evidence that non-profit disease management programs led by health professionals improve quality.

  12. Private insurers competing with Medicare • Edwards and Obama proposal • Already policy within the Medicare Advantage program

More Related