Tma winter conf 2012 radical change


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  • 14% of US health care costs, or approximately $360 billion per year is spend on administration costs Could smart cards change Medicare? $163 billion, almost ½ of billing costs are borne by Medicare, Medicaid and insurance companies. The other ½ are born by doctors and hospitals. United Health Care electronic billing and credentialing could save $32 billion; 50% to physicians, 30% to insurers, and 20% to government.
  • Germany is the highest in the world
  • Tma winter conf 2012 radical change

    1. 1. <ul><li>Why Is Radical Change Necessary? </li></ul><ul><li>C. Bruce Malone, MD, President </li></ul>
    2. 2. <ul><li>Hospital Spending per Discharge, 2008 </li></ul>* 2007. ** 2006. Source: OECD Health Data 2010 (Oct. 2010) Adjusted for Differences in Cost of Living
    3. 3. <ul><li>Leading health care attorney tells TMA: “Hospitals are a Burning Platform” </li></ul><ul><li>Where are We Now? </li></ul>
    4. 4. <ul><li>Health Care Costs by Age </li></ul>Source: Fischbeck, Paul. “US-Europe Comparisons of Health Risk for Specific Gender-Age Groups.” Carnegie Mellon University; September, 2009.  U.S. is spending much more for older ages
    5. 5. <ul><li>Myths & Realities of Cost Savings </li></ul><ul><li>$2.6 Trillion in 2010 </li></ul><ul><li>U.S. Health Care Costs = 5 th Largest Economy in the World </li></ul><ul><li>Grew 2% Faster Than Overall Economy </li></ul><ul><ul><li>For 30 Years </li></ul></ul><ul><ul><li>$100 Billion Increase per Year </li></ul></ul><ul><li>How Can We Save 1% = $26 Billion? </li></ul>
    6. 6. <ul><li>Myth 1: Insurance Company Profits </li></ul><ul><li>Total Profits of 5 Largest Insurers </li></ul><ul><li>$11.7 Billion </li></ul><ul><li>0.5% of Total U.S. Health Care Costs </li></ul>
    7. 7. <ul><li>Myth 2: Brand Name Drugs </li></ul><ul><li>Pharmaceutical Costs = 10% U.S. Health Care Spending = $260 Billion </li></ul><ul><li>From 2004 to 2009 </li></ul><ul><ul><li>Generics Go From 57% to 75% of All Drugs </li></ul></ul><ul><ul><li>Pharmaceutical Costs Increase 31% </li></ul></ul><ul><li>Import Brand Name Drugs from Canada </li></ul><ul><ul><li>Saves $5 Billion = 0.2% All Health Care $$$ </li></ul></ul>
    8. 8. <ul><li>$250K Cap on Noneconomic Damages </li></ul><ul><li>$500K Cap on Punitive Damages </li></ul><ul><li>$11 Billion Savings with 1-Year Statute of Limitations </li></ul><ul><li>$5 Billion Savings from 40% Cut in Liability Premiums </li></ul><ul><li>$6 Billion Savings from Decreased Defensive Medicine </li></ul><ul><ul><li>Secondary to Training? </li></ul></ul><ul><li>Myth 3: Medical Liability Reform </li></ul>
    9. 9. <ul><li>How Do We Tell In Advance Which Patients Will Cost Over $50,000? </li></ul><ul><li>Review of 20 Million Commercial Patients </li></ul><ul><ul><li>Only 255 Patients Consumed Over $1 Million In 2010. </li></ul></ul><ul><ul><li>That’s 0.5% of All Costs </li></ul></ul><ul><li>Myth 4: Expensive Patients </li></ul>
    10. 10. <ul><li>Billions of Wasted Dollars </li></ul><ul><li>Administration Costs </li></ul><ul><ul><li>14% of US Health Care Costs </li></ul></ul><ul><ul><li>$360 Billion per Year </li></ul></ul><ul><ul><li>Half Borne by Payers </li></ul></ul><ul><ul><li>Half Borne by Doctors and Hospitals </li></ul></ul><ul><li>Reality: The Cost of Billing </li></ul>
    11. 11. <ul><li>10% of Us Account for 64% of Health Care Spending </li></ul><ul><li>Most Have One or More of Seven Chronic Diseases </li></ul><ul><li>Reducing Avoidable Complications by 10% Saves $40 Billion a Year </li></ul><ul><li>More Savings Through Better Tertiary Prevention </li></ul><ul><li>Reality: The Cost of Chronic Care </li></ul>
    12. 12. <ul><li>Massive conversion to outpatient surgery </li></ul><ul><li>Dramatic drop in length of stay </li></ul><ul><li>Our Biggest Money Savers </li></ul>