Concept: Healthcare reform
With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc.
Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries.
Last December, Vermont Governor Peter Shumlin ended a 4-year initiative to create a single-payer health care system. The plan was abandoned because of legitimate political considerations, and any other state considering single payer will face similar obstacles.
Since the Affordable Care Act (ACA) was passed in 2010, our health care system has changed for the better. The uninsured rate has fallen by 45%, and for the first time, more than 9 in 10 Americans have health insurance. Health care spending per beneficiary has grown more slowly in both the private and public sectors, and we’ve seen promising improvements in health care quality, including lower rates of hospital-acquired conditions and hospital readmissions - a sign that we are not just cutting costs but also delivering greater value. Nevertheless, work remains to be done to build a health care . . .
About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.
The Affordable Care Act (ACA) has passed its fifth birthday and completed two enrollment periods for coverage in the state-based insurance exchanges and Medicaid. The U.S. uninsured rate is lower than ever, and coverage gains appear to be improving access to primary care and medications, affordability of care, and self-reported health.(1) But challenges for health care reform persist: millions of Americans are still uninsured, and even for those with coverage, substantial barriers remain to obtaining affordable, high-quality care. More than 30 million U.S. children and adults still lack insurance (see pie chart). Who are they, and what policy options exist for covering . . .
With politicians and pundits clamoring in the background, the first open-enrollment period - created by the Affordable Care Act (ACA) for Americans seeking insurance coverage in the new individual marketplaces - came to a close on March 31. There were last-minute extensions by the Department of Health and Human Services and by certain states, but for most insurance seekers, March 31 was the last chance to enroll through the individual marketplaces until the next open-enrollment period launches in November. Americans who did not have qualified health insurance when open enrollment ended and who do not qualify for an exemption will . . .
Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7.2 percent), hospital care (5.6 percent), and physician and clinical services (6.3 percent). Continued strong growth in Medicaid (9.7 percent) and retail prescription drug spending (9.0 percent), albeit at a slower rate than in 2014, contributed to overall health care spending growth in 2015.
The Affordable Care Act (ACA) will cause a major expansion of high-deductible health insurance, a fact that has received little attention but has substantial implications for patients, health care providers, and employers. High-deductible health plans (HDHPs), often considered “blunt instruments” that indiscriminately reduce utilization of both appropriate and discretionary care, require annual out-of-pocket payments of $1,000 to $10,000 for many services before more comprehensive coverage begins.(1) Unfortunately, large gaps remain in our understanding of HDHPs' effects on vulnerable populations, life-saving services, and health outcomes.(2),(3) In the ACA, Congress chose market-based cost controls over measures that are common internationally, such . . .
“Moving from volume to value” is health care reform’s latest mantra. Policymakers hope to replace fee-for-service systems with value-based approaches that reward improved outcomes achieved at lower cost. Ground zero in these efforts is the Medicare Physician Fee Schedule (MPFS). What payment reformers often fail to recognize is that the specific MPFS payment rates have important implications for Medicare and its beneficiaries. The relative payment levels for the thousands of service codes and the absence of payment for other activities powerfully influence how physicians spend their time - and their tendency to perform unneeded tests and procedures. The mix of . . .