National health expenditure projections, 2016-25: Price increases, aging push sector to 20 percent of economy

Health Affairs

Volumn 36, Issue 3, 2017, Pages 553-563

  Keehan, Sean P ^a   Stone, Devin A ^b   Poisal, John A ^c   Cuckler, Gigi A ^b   Sisko, Andrea M ^b   Smith, Sheila D ^b   Madison, Andrew J ^b   Wolfe, Christian J ^b   Lizonitz, Joseph M ^b  

^a CENTERS FOR MEDICARE AND MEDICAID SERVICES   (United States)

^b CMS Office of the Actuary   (United States)

^c National Health Statistics Group   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

PRESCRIPTION DRUG;

ACCOUNTING; AGING; ARTICLE; ECONOMIC ASPECT; GOVERNMENT; GROSS NATIONAL PRODUCT; HEALTH CARE; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH SERVICE; HUMAN; MEDICAID; MEDICAL FEE; PRIVATE HEALTH INSURANCE; PUBLIC HEALTH; COMMERCIAL PHENOMENA; ECONOMICS; FORECASTING; HEALTH INSURANCE; INSURANCE; MEDICARE; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES;

AGING; COMMERCE; FORECASTING; GROSS DOMESTIC PRODUCT; HEALTH EXPENDITURES; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICAID; MEDICARE; PRESCRIPTION DRUGS; UNITED STATES;

EID: 85014636612     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2016.1627     Document Type: Article

References (19)

1. One exception is that the projections assume that the level of funding for the Children's Health Insurance Program does not expire throughout the projection period.
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4. These projections assume that the laws and regulations in effect in 2016 remain in place for the entire projection period.
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11. Risk mitigation payments are payments from managed care organizations to states and the federal government (and vice versa) to settle contractual arrangements. These contracts contained risk mitigation strategies such as risk corridor arrangements or minimum medical loss ratio requirements that provided protection against large losses. Because the rates that the government paid managed care organizations to provide care to beneficiaries in 2014 and 2015 ended up being above their actual cost, these managed care organizations returned a portion of that money to the government in 2016. Those payments were recorded as a reduction in the net cost of health insurance.
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19. The biggest impact is usually seen in the year following the patent's expiration. For many drugs losing patent protection, there are restrictions in the number of generic competitors for the first six months after patent expiration, which mean lower immediate price declines, and some patents expire late in the year.