A recent national survey by Deloitte and Associates (bit.ly/DeloitteMACRA) suggests there is a significant lack of awareness and readiness among physicians about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its potential long-term impact on reimbursement. The recent election results and aftermath have cast even further doubt on the future of health insurance and reimbursement reform, but nevertheless suggest that health care policy activities (legislation and regulation) will remain at the forefront for the foreseeable future.
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Why? Because health care is expensive and getting more expensive. It is important for practicing physicians on the front lines of care delivery to have a passing knowledge of the cost of health care from a larger perspective than their own practice. The Centers for Medicare & Medicaid Services just released its annual report, “National Health Spending: Faster Growth In 2015 As Coverage Expands and Utilization Increases” (Health Aff [Millwood], Epub ahead of print, Dec. 2, 2016). In this article, I will summarize some of the key findings of the report and explain its relevance to practicing urologists.
Just how much do we spend on health care? According to the report, spending on health care in the U.S. reached $3.21 trillion in 2015. That represents almost $10,000 per person, or 17.8% of the U.S. gross domestic product. For context, health care expenditures in this country are usually compared to those of other economically developed countries. While our delivery systems are significantly different, it is possible to compare costs and in some cases outcomes. According to the Organisation for Economic Co-operation and Development, the U.S. leads all peer countries in health care spending as a percentage of GDP (bit.ly/OECDhealthspending)—more than twice the average and one and a half times more than the second-costliest country (Switzerland).
Spending per capita shows similar relative spending. Growth in spending is up slightly from last year at 5.8%, slightly more than CMS predicted earlier this year (5.5%), higher than 2014 (5.3%), and significantly higher than growth in 2013 (3.8%). While some argue that these growth rates have slowed since the passage of the Affordable Care Act, U.S. health care is expensive and getting more expensive by any index.