What will become of the medical mecca? Health care spending in Massachusetts

Health Affairs

Volumn 22, Issue 6, 2003, Pages 130-141

  Mechanic, Robert E ^a  

^a Robert Mechanic and Associates   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMMUNITY HOSPITAL; COMPARATIVE STUDY; ECONOMICS; FORECASTING; HEALTH CARE COST; HEALTH INSURANCE; HOSPITAL COST; HUMAN; MEDICARE; STATISTICS; UNITED STATES; UNIVERSITY HOSPITAL; UTILIZATION REVIEW;

ACADEMIC MEDICAL CENTERS; FORECASTING; HEALTH CARE SECTOR; HEALTH EXPENDITURES; HOSPITAL COSTS; HOSPITALS, COMMUNITY; HUMANS; INSURANCE, HOSPITALIZATION; MASSACHUSETTS; MEDICARE; UNITED STATES;

EID: 1542435094     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.22.6.130     Document Type: Review

References (42)

1. A. Sager et al., The World's Most Expensive Hospitals (Boston: Access and Affordability Monitoring Project, 1991);
2. and A. Sager and D. Scholar, The World's Most Expensive Health Care: Massachusetts Health Care Costs, 1980-1998 (Boston: Access and Affordability Monitoring Project, 2000).
3. AHCs are defined as teaching hospitals under common ownership with a medical school and those in which the majority of the chiefs of service also serve as department chairs at the medical school. Based on 1999 data, Massachusetts has a higher proportion of inpatient hospital days in AHCs than all states except the District of Columbia. New York State has a higher proportion of days in AHCs and major teaching hospitals combined.
4. J.H. Grossman, An Economic History of Health Care in Massachusetts, 1990-2000 (Boston: Pioneer Institute for Public Policy Research, 2000).
5. Tillinghast-Towers Perrin, unpublished analysis, July 2002.
6. A. Pham, "State Seeks Oversight of Ailing Blue Cross," Boston Globe, 22 May 1997.
7. Medicare hospital margins reached a peak in 1997 prior to enactment of the Balanced Budget Act. See, for example, MedPAC, Report to the Congress: Medicare Payment Policy (Washington: MedPAC, 2003);
8. and A. Dobson et al., Financial Performance of Academic Health Center Hospitals, 1994-2000 (New York: Commonwealth Fund, 2002).
9. Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy (Washington: MedPAC, 2001).
10. Major teaching hospitals are defined as institutions with twenty-five or more residents per 100 staffed beds. AHCs are treated as a distinct category.
11. Lewin Group, Analysis of the Reimbursement Rates for Acute Hospitals, Nonacute Hospitals, and Community Health Centers (Falls Church, Va.: Lewin Group, 2001).
12. R.E. Mechanic et al., "Teaching Hospital Costs: Implications for Academic Missions in a Competitive Environment," Journal of the American Medical Association 280, no. 11 (1998): 1015-1019;
13. and Commonwealth Fund Task Force on Academic Health Centers, Envisioning the Future of Academic Health Centers (New York: Commonwealth Fund, February 2003).
14. In a review of 2001 audited financial statements of eight Boston hospitals, the author identified research revenues of approximately $1.1 billion.
15. "Medicare Program: Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2003 Rates," Federal Register 67, no. 148 (2002): 50214-50224.
16. ACCRA, "ACCRA Cost of Living Index" for the first quarter of 2003, www.coli.org (15 August 2003).
17. A. Martin et al., "Health Care Spending during 1991-1998: A Fifty-State Review," Health Affairs (July/Aug 2002): 112-126.
18. Centers for Medicare and Medicaid Services, National Health Accounts: Definitions, Sources, and Methods Used in the NHE 2001, cms.hhs.gov/statistics/ nhe/definitions-sources-methods (18 September 2003).
19. Hewitt Associates, "Health Care Cost Increases Expected to Continue Double-Digit Pace in 2003," 14 October 2002, was4.hewitt.com/hewitt/ resource/newsroom/pressrel/2002/10-14-02.htm (25 April 2003);
20. and Mercer Human Resources Consulting, "Rate Hikes Pushed Employers to Drop Health Plans, Cut Benefits in 2002 - but Average Cost Still Rose," 9 December 2002, www.mercerhr.com/pressrelease/details.jhtml/dynamic/idContent/ 1076975 (25 April 2003).
21. Massachusetts Health Care Task Force, Final Report 2002, www.state.ma.us/healthcare/pages/pdf/final.pdf (18 September 2003), 31.
22. J.Z. Ayanian and J.S. Weissman, "Teaching Hospitals and Quality of Care: A Review of the Literature," Milbank Quarterly 80, no. 3 (2002): 569-593.
23. R.S. Galvin, "An Employer's View of the U.S. Health Care Market," Health Affairs (Nov/Dec 1999): 166-170.
24. M.N. Marshall et al., "The Public Release of Performance Data: What Do We Expect to Gain? A Review of the Evidence," Journal of the American Medical Association 283, no. 14 (2000): 1866-1874.
25. Standard and Poor's/DRI, The Massachusetts Health-Care Industry: A Stalled Engine of Economic Growth (Burlington: Massachusetts Hospital Association, 2000).
26. L. Kowalczyk, "Hiring for Health Care Is Surging in Bay State," Boston Globe, 29 January 2003.
27. L. Kowalczyk, "Hiring for Health Care Is Surging in Bay State," Boston Globe, 2003, Ibid.;
28. and Standard and Poor's/DRI, The Massachusetts Health-Care Industry.
29. Boston Consulting Group, MassBiotech 2010: Achieving Global Leadership in the Life Sciences Economy (Cambridge: Massachusetts Biotechnology Council, 2002).
30. R. Kerber, "Economists Say Life Sciences Offer Great Promise for State," Boston Globe, 13 September 2003.
31. D. Blumenthal et al., Understanding the Social Missions of Academic Health Centers (New York: Commonwealth Fund, 1997).
32. L. Kowalczyk, "Health Insurance to Jump: Cities, Towns Face Latest Fiscal Blow," Boston Globe, 12 April 2003.
33. L. Kowalczyk, "Health Insurance to Jump: Cities, Towns Face Latest Fiscal Blow," Boston Globe, 2003 Ibid.;
34. and Massachusetts Health Care Task Force, Final Report.
35. L. Kowalczyk, "HMOs Eyeing Surcharge for High-End Care; Some '02 Plans Affect Visits to Medical Centers," Boston Globe, 28 August 2001.
36. B.C. Strunk et al., Health Plan-Provider Showdowns on the Rise, Issue Brief no. 40 (Washington: Center for Studying Health System Change, June 2001).
37. B.C. Strunk and P.C. Ginsburg, "Tracking Health Care Costs: Trends Stabilize but Remain High in 2002," 11 June 2003, www.healthaffairs.org/ WebExclusives/Strunk_Web_Excl_061103.htm (15 August 2003). In a 1 June 2003 interview with the Boston Globe, Tufts Health Plan CEO Nancy Learning said that utilization drives 60 percent of the increase in medical care cost.
38. Institute of Medicine, Crossing the Quality Chasm: A New Health System for the Twenty-first Century (Washington: National Academies Press, 2001).
39. R.E. Mechanic et al., Proactive Medical Management (Cambridge: Forrester Research, 2001).
40. R.S. Williams et al., "Personalized Health Planning," Science 300, no. 5619 (2003): 549.
41. D.W. Bates et al., "Effect of Computerized Physician Order Entry and a Team Intervention on Prevention of Serious Medication Errors," Journal of the American Medical Association 280, no. 15 (1998): 1311-1316.
42. S. Leatherman et al., "The Business Case for Quality: Case Studies and an Analysis," Health Affairs (Mar/Apr 2003): 17-30.