Dan L. Crippen, director, Congressional Budget Office, testimony before the Senate Finance Committee, 22 July
Dan L. Crippen, director, Congressional Budget Office, testimony before the Senate Finance Committee, 22 July 1999, available online at www.cbo.gov.
(1999)
2
85037454477
note
Medicare now pays for certain outpatient drugs, such as intravenous chemotherapy drugs that must be administered under the direction of a physician. Those drugs would continue to be covered under Part B rather than Part D.
3
85037489356
note
Memorandum written by Richard Foster, Office of the Actuary, Health Care Financing Administration, 9 August 1999, Table 4.
4
85037452137
note
The CBO multiplied drug spending reported by noninstitutionalized respondents in the MCBS by 1.33 to correct for underreporting, while HCFA used an adjustment factor of 1.3. This adjustment assumes that underreporting for drugs, on average, was similar to the known underreporting for spending on physician services. The extent of underreporting in the survey on physician and other Medicare-covered services is known because survey responses can be compared with Medicare claims paid for the same person and time period.
5
85037456967
note
The CBO used drug spending reported in the MCBS by community residents to impute drug spending for residents of nursing homes, for whom little or no information on spending was available. Nursing home residents were matched to community residents based primarily on the number of limitations they faced in activities of daily living (ADLs). As a result, total spending on drugs by the survey population was increased by about 10 percent.
6
0001640011
Health Spending in 1998: Signals of Change
Jan/Feb Exhibit 2
K. Levit et al., "Health Spending in 1998: Signals of Change," Health Affairs (Jan/Feb 2000): 124-132, Exhibit 2.
Projections of per capita spending on prescription drugs for 1998-2008 were taken from the HCFA Web site, accessed 1 July 1999; still current as of 3 January 2000
Projections of per capita spending on prescription drugs for 1998-2008 were taken from the HCFA Web site, www.hcfa.gov/stats/nhe-proj/proj.1998/tables/tablel2b.htm (accessed 1 July 1999; still current as of 3 January 2000).
8
0023353908
Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment
June
The CBO uses an arc elasticity of -0.11 to estimate an individual's change in drug utilization in response to a change in the out-of-pocket costs they would face. See W. Manning et al., "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review (June 1987): 251-277.
Effects of Medicaid Drug-Payment Limits on Admission to Hospitals and Nursing Homes
10 October
S.B. Soumerai et al., "Effects of Medicaid Drug-Payment Limits on Admission to Hospitals and Nursing Homes," New England Journal of Medicine. (10 October 1991): 1072-1077; and S.B. Soumerai et al., "Effects of Limiting Medicaid Drug-Reimbursement Benefits on the Use of Psychotropic Agents and Acute Mental Health Services by Patients with Schizophrenia," New England Journal of Medicine (8 September 1994): 650-655.
Effects of Limiting Medicaid Drug-Reimbursement Benefits on the Use of Psychotropic Agents and Acute Mental Health Services by Patients with Schizophrenia
8 September
S.B. Soumerai et al., "Effects of Medicaid Drug-Payment Limits on Admission to Hospitals and Nursing Homes," New England Journal of Medicine. (10 October 1991): 1072-1077; and S.B. Soumerai et al., "Effects of Limiting Medicaid Drug-Reimbursement Benefits on the Use of Psychotropic Agents and Acute Mental Health Services by Patients with Schizophrenia," New England Journal of Medicine (8 September 1994): 650-655.
For a review of the frequency of medication errors, see Institute of Medicine, To Err Is Human: Building a Safer Health System, ed. L.T. Kohn, J.M. Corrigan, and M.S. Donaldson (Washington: National Academy Press, 1999).
