Class 2: Estimating the size and structure of the US Health Industry -1980 to 2000

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Class 2 Estimating the size and structure of the
US Health Industry -1980 to 2000

• Two emphases
• 1. The tools CMS uses to estimate size and
  structure of the US Health Industry
• 2. Interpreting the estimates published by CMS

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U.S. National Health Accounts (NHA)(http//www.cm
s.gov/statistics/nhe)

• Starting in 1964, HHS has published annual
  statistics on national health expenditures.
• The NHA define sources of health expenditures and
  medical services exchanged for these
  expenditures.
• By maintaining a consistent set of these
  definitions, the NHA can compare NHE over time.
• Each health transaction is entered twice into the
  NHA - as an expenditure and a payment. This
  double-entry set-up enables NHA statisticians to
  compare expenditures against payments to check
  NHE estimates for accuracy.

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The NHA Are Grouped Into Various Configurations
That Measure Key Trends in Health Policy Debates
(http//www.cms.gov/statistics/nhe/historical/t3.a
sp)

• PHE as a portion of GDP
• PHE by various sources of funds
• Over time, changes in the sources-of-funds
  structure
• Payments for various types of services
• Over time, changes in the types-of-services
  structure
• Projections

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National Health Expenditures(NHE) by objects

• Health services and supplies
• Personal Health Care (PHC)
• Program administration and net cost of private
  health insurance
• Government public health activities
• Research and construction
• Research
• Construction

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NHE by Sources of Funds

• Out-of-pocket expenditure
• Private health insurance
• Non-patient revenue and philanthropy
• Medicare
• Medicaid
• State and local government hospital subsidy
• Other government programs (SCHIP)

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Deflating PHC Expenditures

• Deflating health care spending separates the
  effects of price growth from growth attributable
  to all other factors.
• PHC expenditure fixed weight price index (M-CPI).
  Based on surveys taken by the Department of
  Labor.
• M-CPI is used to deflate current annual estimates
  of personal health care expenditures. This
  technique is used to eliminate the impact of
  market changes on PHC expenditures.
• Comments on current concerns about M-CPI