What changes have kept healthcare spending down

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Complex and slow-to-change policies are an obvious factor, but environmental and technological factors also contribute to changes in healthcare.

Illness trends, doctor demographics, and technology also contribute to shifts in our overall healthcare system. As our society evolves, our healthcare requirements naturally evolve. Healthcare reform has often been proposed but has rarely been accomplished. Speaker of the House Thaddeus Sweet vetoed the bill in committee.

In , after 20 years of congressional debate, President Lyndon B. Johnson enacted legislation that introduced Medicare and Medicaid into law as part of the Great Society Legislation.

Since becoming law, additional rules and regulations have expanded upon the Patient Protection and Affordable Health Care for America Act. Choosing a healthcare plan illustrates the complexity of health insurance plans in the U. About half of Americans who have private health insurance are covered under self-insured plans, each with their own design. The one commonality among all insurance plans is how dramatically they vary. Deductibles, co-insurance, co-payments, and maximum out-of-pocket expenses are a few of the inconsistent variables among insurance plans.

Additionally, some insurance companies are for-profit and others are not-for-profit, indicating another point of confusion. Insurance is not the only complexity within the system. The Affordable Care Act added more agencies to this list, including state insurance exchanges and the Center for Medicare and Medicaid Innovation.

Each area of healthcare has its own complexities. As components of the larger healthcare system work together, the complex layers unfold. While change is expected in the coming years, it is likely to occur slowly. Changes in the healthcare industry usually occur at the legislative level, but once enacted these changes have a direct impact on facility operations and the use of resources.

For example, the ways patients and administrators utilize resources such as Medicare and Medicaid have changed due to legislation. Technology has had a further impact on how healthcare administrators handle resources and manage medical centers.

Cultural shifts, cost of care, and policy adjustments have contributed to a more patient-empowered shift in care over the last century. Technological advancements contribute to a shift in our patient-centered healthcare system. This trend is expected to continue as new healthcare electronic technologies , such as 3D printing, wearable biometric devices, and GPS tracking, are tested and introduced for clinical use.

Policies and procedures in individual facilities may restrict how and when new technologies are introduced, but cutting-edge technology is expected to play an increasingly larger role in our healthcare system within the coming years.

As legislative and demographic changes trickle down into care facilities, the use of hospital services is expected to grow significantly between and This growth is due to an anticipated increase in Medicare beneficiaries in the coming decade. The cost of hospital care is expected to rise from 0. Since then, Congress has made Medicare and Medicaid changes to open eligibility to more people. For example, Medicare was expanded in to cover the disabled, people over 65, and others.

Medicare includes more benefits today, including limitless home health visits and quality standards for Medicare-approved nursing homes. Medicaid has also been expanded to cover a larger group than initially intended. This includes coverage for low-income families, pregnant women, people requiring long-term care, and people with disabilities.

Wide variations in Medicaid programs across the nation occur because individual states have the ability to tailor Medicaid programs to serve the needs of their residents. Potential consumers can now use the Marketplace website to determine their Medicaid eligibility. As the baby boomer generation approaches retirement, thus qualifying for Medicare, healthcare spending by federal, state, and local governments is projected to increase.

Assuming the government continues to subsidize Marketplace premiums for lower-income populations, this increased government healthcare spending will greatly affect the entire healthcare system in the U. Although Medicaid spending growth decelerated in due to reduced enrollment, spending is expected to accelerate at an average rate of 7.

Along with policy and technological changes, the people who provide healthcare are also changing. Providers are an important part of the healthcare system and any changes to their education, satisfaction or demographics are likely to affect how patients receive care. Future healthcare providers are also more likely to focus their education on business than ever before. This growth may result in more private practices and healthcare administrators.

In recent years, the demographics of the medical profession have shifted. Women currently make up the majority of healthcare providers in certain specialties, including pediatrics and obstetrics and gynecology.

Nearly one-third of all practicing physicians are women. According to an Association of American Medical Colleges AAMC analysis, women comprise 46 percent of all physicians in training and nearly half of all medical students. Based on these statistics, we can assume more women may enter the medical profession in the coming years. African-American women are more likely to become doctors than their male counterparts, according to AAMC data.

While African-Americans comprise only four percent of the physician workforce, 55 percent of the African American physician workforce is female. This shift in demographics to include more women in healthcare supports diversity in the industry and represents overall population diversity. The prevalence of malpractice lawsuits is one way to evaluate the competence of healthcare providers. The amount of malpractice claims in the U. As the trend of declining malpractice lawsuits continues, it may indicate that provider competence and patient care will continue to improve.

Job satisfaction is one area that must improve. Nurses report higher overall career satisfaction than doctors, based on results of the latest Survey of Registered Nurses conducted by AMN Healthcare and compared to the Physician Compensation Report.

Nine out of 10 nurses who participated in the survey said they were satisfied with their career choice. However, one out of every three nurses is unhappy with their current job. It is difficult to say whether job satisfaction will increase in the coming years, but continued technological advancements designed to streamline the healthcare process offer hope to those who may be frustrated with the complexity of their jobs.

Demands on healthcare change due to various reasons, including the needs of patients. Every year, new cures and treatments help manage common diseases. In a recent Health Affairs report, Ryu and associates analyzed insurance data on more than 10 million enrollees who were covered by large companies between and Their analysis revealed that out-of-pocket costs did in fact go up during that period.

According to their calculations, these changes account for about a fifth of the recent decrease in U. They also found that when changes in insurance benefits were factored out of the equation, the drop in U.

Consumer surveys have found that patients have put off about 20 percent of elective procedures, Keckley noted, and that may suggest changes in health insurance design are partially responsible for putting the brakes on healthcare spending.

But more revealing is that the GDP was down about 1. Economists estimate that about 37 percent of the slowdown in health spending between and resulted from the recession itself, said Riley. But there are several other forces at play here, he noted. Riley echoed the Health Affairs report, saying that increased out-of-pocket costs for consumers are driving some of the decreased healthcare spending.

The other major factor, he said, has been the introduction of the Affordable Care Act and its mandates. Still, national health spending will accelerate in , jumping to a 6. Health reform changes taking effect in , including enrolling individuals through insurance exchanges and expanding Medicaid, will drive more spending, as well as expectations that the economy will gain steam. National health spending will increase 1. In , over 11 million people will gain coverage, with 2.

Some states anticipate expanding their Medicaid programs after , so an additional 8. In , the spending will back off somewhat to a 5. Skip to main content. Hospitals disappointed by court decision leaving B repayment to HHS. Revenue Cycle Management. High out-of-pocket costs are affecting revenue cycles. Strategic Planning.

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