Healthcare Flashcards
what are main components of affordable healthcare act?
individual mandate
exchanges
Medicaid expansion
cost reduction programs
what are some of the cost reduction provisions
minimum loss ratios (overhead and profits)
rate cuts
how much of healthcare systems come from hospitals
1 / 3
how many people will be newly insured
10% although primarily poor and preexisting conditions
the 5% sickest of the uninsured population account for how much of spending by status?
uninsured: 66%
public: 55%
private: 50%
according to CBO, how high must a tax penalty be in terms of premium to incentivize purchase?
50%
what is US annual healthcare bill?
$2.7 trillion (or xx% of GDP)
what issues were considered and what was decision of supreme court
individual mandate: could be considered tax
Medicaid expansion: states could elect to take funds or refuse
90% of the uninsured make less than $ per year?
$45k
how much higher are retail prices at hospital than medicare?
10x
how are exchanges suppose to drive cost reductions?
consolidation = negotiating power (need volume) and less cherry picking highest margin customers
what were primary outcomes from MA?
- uninsured fell from 6.4% to 1.9%
- MLR spiked (making some insures unprofitable) - because didn’t have enrollment windows
- Margins decreased from 4.2% to 0.8%
- Shortage of doctors (2x DC and 7X Philli despite highest primary care to patient ratio in US)
- Preventative care has not reduced ER visits
- Premiums have continued to rise
distribution of health care by expenditure by insurance status
status: top 5% / top 10% / top 25% / top 50%
uninsured: $17k, $10k, $5k, $3k
public insured: $43k, $28k, $14k, $7k
private: $34k, $22k, $12k, $7k
what is evidence for increased demand when someone becomes newly insured?
Medicaid HMOs report 8-20% higher costs for new enrollees and high MLRs for first 6 months on new members
how much of a hospitals costs are labor? bad debt?
45%
10%
