A series of small tweaks could help reduce US health care spending. Health care in the US costs nearly twice as much as that of its peer countries, without improved outcomes. Some policymakers have examined whether there could be a broad fix – such as a single-payer system or improvements in end-of-life care – to make the system less expensive. But the answer could actually be a series of small tweaks. A group of economists has begun examining whether policy changes, sometimes in small slices of the health care system, could lead to savings of about one percent of the nation’s $3.3 trillion yearly health bill. These, in turn, could lead to more substantial savings, they added. In the Eighties, Congress selected a small group of “long-term care hospitals”, which treated patients with chronic diseases, to be exempt from its normal rules for payments. They could earn far more than traditional ones if they cared for patients who stayed with them for an average of 25 days. Since then, the number of such hospitals have grown from over 400 to a few dozen. Analysts have since wondered about the value of these sites, with some suggested Medicare may be overpaying for their services. In a study covering 1990 to 2014, researchers from the Massachusetts Institute of Technology and the University of Chicago examined what happened to patients as these long-term hospitals opened in places that had none. They found that when such a facility opened, the odds that very sick patients would go to one increased, meaning a higher bill for Medicare and the patients themselves, but there was no benefit when it came to patients’ chances of dying or going home within 90 days. As such, researchers concluded that the health care system could probably save about $5 billion per annum by paying long-term care hospitals the same prices that are paid to skilled nursing facilities, where most long-term patients end up when there is no equivalent hospital nearby. If they are correct, the savings would be within this one percent range. The hospital industry disagrees, disputing the assertion that the extra money they get is wasteful. The American Hospital Association said that Congress has changed rules for long-term care units so fewer patients qualify for higher patients since the study ended. This means that results could be different if they looked at more recent long-term hospital care, it added.
A series of small tweaks could help reduce US health care spending. Health care in the US costs nearly twice as much as that of its peer countries, without improved outcomes. Some policymakers have examined whether there could be a broad fix – such as a single-payer system or improvements in end-of-life care – to make the system less expensive. But the answer could actually be a series of small tweaks. A group of economists has begun examining whether policy changes, sometimes in small slices of the health care system, could lead to savings of about one percent of the nation’s $3.3 trillion yearly health bill. These, in turn, could lead to more substantial savings, they added. In the Eighties, Congress selected a small group of “long-term care hospitals”, which treated patients with chronic diseases, to be exempt from its normal rules for payments. They could earn far more than traditional ones if they cared for patients who stayed with them for an average of 25 days. Since then, the number of such hospitals have grown from a few dozen to over 400. Analysts have since wondered about the value of these sites, with some suggested Medicare may be overpaying for their services. In a study covering 1990 to 2014, researchers from the Massachusetts Institute of Technology and the University of Chicago examined what happened to patients as these long-term hospitals opened in places that had none. They found that when such a facility opened, the odds that very sick patients would go to one increased, meaning a higher bill for Medicare and the patients themselves, but there was no benefit when it came to patients’ chances of dying or going home within 90 days. As such, researchers concluded that the health care system could probably save about $5 billion per annum by paying long-term care hospitals the same prices that are paid to skilled nursing facilities, where most long-term patients end up when there is no equivalent hospital nearby. If they are correct, the savings would be within this one percent range. The hospital industry disagrees, disputing the assertion that the extra money they get is wasteful. The American Hospital Association said that Congress has changed rules for long-term care units so fewer patients qualify for higher patients since the study ended. This means that results could be different if they looked at more recent long-term hospital care, it added.